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Now that the majority of patients in the western hemisphere reaches adulthood, end organ diseases are frequent, which include vasculopathic complications such as chronic leg ulcers. The management of patients with leg ulcers requires the hematologist to lead a team of health care professionals, and investigates the presence of associated, but potentially still occult signs of vasculopathy, such as pulmonary hypertension, renal disease, priapism and retinopathy. These complications may be asynchronous, and long term careful screening is indicated, in order to ensure early diagnosis and intervention. It is crucial to address both the immediate consequences of pain, infection and disability, and long term effects on quality of life, employment and stigma associated with chronic ulceration. Recent insights into their pathophysiology may have practical implications. We propose a holistic approach to the management of patients' physical and emotional problems and mechanisms of ulcers formation and delayed healing. An overview of topical and systemic therapies for chronic ulcers is given, with the understanding that wound care therapy is best left to the wound specialists, medical and surgical, with whom the hematologist must keep an open line of communication. In the absence of evidence\u2010based guidelines, our opinion is based on both a critical review of the literature and our personal clinical and research experience. Am. J. Hematol. 00:000\u2013000, 2015. \u00a9 2015 Wiley Periodicals, Inc. Am. J. Hematol. 91:22\u201330, 2016. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajh.24134","type":"journal-article","created":{"date-parts":[[2015,8,7]],"date-time":"2015-08-07T23:27:12Z","timestamp":1438990032000},"page":"22-30","source":"Crossref","is-referenced-by-count":74,"title":["Critical Reviews: How we treat sickle cell patients with leg ulcers"],"prefix":"10.1002","volume":"91","author":[{"given":"Caterina P.","family":"Minniti","sequence":"first","affiliation":[{"name":"Division of Hematology\u2010Oncology, Department of Medicine Montefiore Medical Center Bronx New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory J.","family":"Kato","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology, Department of Medicine and the Heart, Lung Blood and Vascular Medicine Institute, University of Pittsburgh Pittsburgh 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