In an Iraqi Jewish family, Winkler et al. (1991) observed 11 males in 7 sibships with leg ulcers of early onset. The 27-year-old propositus, for example, had bilateral, recurrent, lateral and medial malleolar leg ulcers that had first ... In an Iraqi Jewish family, Winkler et al. (1991) observed 11 males in 7 sibships with leg ulcers of early onset. The 27-year-old propositus, for example, had bilateral, recurrent, lateral and medial malleolar leg ulcers that had first appeared when he was 11 years old. Two of the propositus' 3 brothers were similarly affected. Three sisters were free of ulcerations. There were no varicosities and venous studies did not suggest that venous insufficiency was the main or only cause of the leg ulcerations. The disorder did not, furthermore, satisfy the criteria for Buerger disease (211480). There were many instances of male-to-male transmission. Autosomal dominant male-limited inheritance was suggested. Angle and Burton (1998) described a 23-year-old black man who had had leg ulcers since the age of 15 years. No evidence of hematologic abnormality, i.e., hemoglobinopathy or hemophilia, could be demonstrated. There was no history of deep vein thrombosis, and previous arteriography, venography, and Doppler ultrasound studies were normal. Family history was remarkable for 5 maternal male relatives who had chronic leg ulcers with onset ranging from their mid-teens to early twenties. The 6 affected males were distributed through 4 generations and 4 different sibships connected by females. Angle and Burton (1998) suggested X-linked recessive inheritance; autosomal dominant male-limited inheritance, suggested by Winkler et al. (1991), is equally plausible.