Leg ulcers in patients with myeloproliferative disorders: disease- or treatment-related?
Leg ulcers are a relatively frequent problem in patients with myeloproliferative disorders under treatment with hydroxyurea (HU). The pathogenesis is currently unknown and may be multifactorial. Concomitant arterial or venous disease may play a contributing role in the development of these wounds. Vasculitis, cryoglobulinemia and pyoderma gangrenosum should be considered if typical clinical signs are present. We report on 3 patients with myeloproliferative disorders who developed HU-induced leg ulcers and review the literature. HU-induced leg ulcers share clinical features which can help to differentiate them from leg ulcers of other etiologies: occurrence under long-term treatment with HU at a dose of at least 1 g/day, localization in the malleolar region and spontaneous healing when HU is discontinued. We conclude that differentiation between disease-related and treatment-induced leg ulcers can be difficult and may not always be possible. In HU-induced leg ulcers, cessation of the drug typically leads to wound healing.
Bader
U
U
Department of Dermatology, University Hospital, Zurich, Switzerland. ubader@derm.unizh.ch
Banyai
M
M
Böni
R
R
Burg
G
G
Hafner
J
J
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006918:Hydroxyurea / Q000009:adverse effects* / Q000627:therapeutic use; D007871:Leg Ulcer / Q000139:chemically induced*; D008297:Male; D009196:Myeloproliferative Disorders / Q000188:drug therapy*; D011086:Polycythemia / Q000188:drug therapy; D013922:Thrombocytosis / Q000188:drug therapy
D000970:Antineoplastic Agents; D006918:Hydroxyurea