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We evaluated the microcirculation of lower extremity ulcers with laser speckle contrast imaging and infrared thermography and obtained clinical and laboratory characteristics in 18 adults with sickle cell anemia and chronic leg ulcers. Skin biopsies were obtained in four subjects. Subjects had markers of severe disease, anemia, high degree of hemolysis, inflammation, and thrombophilia. The highest blood flow was present in the ulcer bed, progressively less in the immediate periwound area, and an unaffected control skin area in the same extremity. Microscopic examination showed evidence of venostasis, inflammation, and vasculopathy. Blood vessels were increased in number, had activated endothelium and evidence of thrombosis\/recanalization. High blood flow may be due to chronic inflammation, cutaneous vasodilatation, venostasis, and in situ thrombosis. These changes in skin microcirculation are similar to chronic venous ulcers in the non\u2010sickle cell disease (SCD) population, thus suggesting that leg ulcers may be another end\u2010organ complication with endothelial dysfunction that appears in patients with SCD at a younger age and with higher frequency than in the general population. Am. J. Heamtol. 89:1\u20136, 2014. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.23571","type":"journal-article","created":{"date-parts":[[2013,8,20]],"date-time":"2013-08-20T12:38:37Z","timestamp":1377002317000},"page":"1-6","source":"Crossref","is-referenced-by-count":79,"title":["Vasculopathy, inflammation, and blood flow in leg ulcers of patients with sickle cell anemia"],"prefix":"10.1002","volume":"89","author":[{"given":"Caterina P.","family":"Minniti","sequence":"first","affiliation":[{"name":"Hematology Branch NHLBI, National Institutes of Health Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara\u2010Marie H.","family":"Delaney","sequence":"additional","affiliation":[{"name":"Hematology Branch NHLBI, National Institutes of Health Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander M.","family":"Gorbach","sequence":"additional","affiliation":[{"name":"Infrared Imaging &amp; Thermometry 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