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Sickle cell disease is an autosomal recessive genetic disorder that affects the shape and function of red blood cells, causing a myriad of systemic complications. Rigid and deformed red blood cells can become trapped in the microvascular circulation, causing tissue ischemia and severe pain. Skin ulcerations of the lower extremities present a unique challenge for patients suffering from this condition. This case study discusses the pathophysiology of these ulcers, treatment options, and a patient case.