Aggressive, extensive, vasculitic leg ulceration associated with hydroxyurea therapy and a fatal outcome.
The association of lower leg ulcer development and hydroxyurea therapy in patients with myeloproliferative disorders has been reported previously. In most of these cases the ulcers healed with cessation of the hydroxyurea together with meticulous attention to wound care. We report a patient who developed painful vasculitic ulcers secondary to hydroxyurea on both lower legs whilst on long-term hydroxyurea therapy for idiopathic thrombocytosis. The ulcers extended relentlessly despite stopping hydroxyurea, maximizing topical therapies and starting intensive systemic treatment. We discuss the association of hydroxyurea therapy with the development of painful ulceration.
Young
H S
HS
Department of Dermatology, University of Manchester School of Medicine, Hope Hospital, Eccles Old Road, Salford, Manchester M6 8HD, UK.
Kirby
B
B
Stewart
E J
EJ
D000368:Aged; D003520:Cyclophosphamide / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D016523:Foot Ulcer / Q000139:chemically induced* / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006918:Hydroxyurea / Q000009:adverse effects*; D016756:Immunoglobulins, Intravenous; D007871:Leg Ulcer / Q000139:chemically induced* / Q000188:drug therapy; D008775:Methylprednisolone / Q000627:therapeutic use; D019384:Nucleic Acid Synthesis Inhibitors / Q000009:adverse effects*; D011239:Prednisolone / Q000627:therapeutic use; D013922:Thrombocytosis / Q000188:drug therapy*
D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D019384:Nucleic Acid Synthesis Inhibitors; D003520:Cyclophosphamide; D011239:Prednisolone; D008775:Methylprednisolone; D006918:Hydroxyurea