Refractory Leg Ulcers Associated with Klinefelter Syndrome

We present a man with refractory leg ulcers, bilateral varicosis of the lower extremities, and Buerger disease. Autoimmune work-up was negative. However, chromosome analysis showed Klinefelter syn- drome (48 XXY). Ulcerative lesions of the lower extremities are a complication of Klinefelter syndrome. To date, the pathogenesis of ulcers in Klinefelter syndrome has not been clarified, but several factors, such as abnormalities of fibrinolysis and prothrombotic states, might be involved. Our present case em- phasizes the importance of considering Klinefelter syndrome in the differential diagnosis of a male pa- tient with nonhealing ulcers of the lower extremities. (J Nippon Med Sch 2015; 82: 64―67)