title: Leg ulcers in elderly on hydroxyurea: a single center experience in Ph- myeloproliferative disorders and review of literature.
abstract: Hydroxyurea (HU) is effective in controlling thrombocytosis while reducing the risk of thrombosis in essential thrombocythemia (ET), polycythemia vera (PV) and myelofibrosis (MF). However, HU may carry more or less severe side-effects. Rare cases of patients with painful leg ulcers have been published. We report our experience on such a side-effect in a large cohort of patients with ET and PV treated with HU and review the literature on the topic. Five (4%) out of our 124 patients (69 ET, 51 PV, 4 MF; 49 males, 75 females; mean age at diagnosis 59.1+/-11.8 years) treated with HU developed painful leg ulcers. Sixty-one other patients affected with Phmyeloproliferative disorders (Ph- MPD) developing HU-related painful leg ulcers are described in the English literature. All our five patients were women and developed leg ulcers over the age of 75. Sixty-five percent of all described cases are women; 59% were over 65 years of age and 45% over 70. Most cases received over 1 gr HU per day for at least 1 year. The pathogenesis of HU-induced skin ulcers remains elusive. Treatment is difficult and requires prompt cessation of HU therapy.
authors.affiliation: Internal Medicine, Department of Medical and Surgical Sciences, University of Padova, 35128 Padua, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Ruzzon
authors.forename: Maria Luigia
authors.initials: ML
authors.lastname: Randi
authors.forename: Fabiana
authors.initials: F
authors.lastname: Tezza
authors.forename: Gguido
authors.initials: G
authors.lastname: Luzzatto
authors.forename: Raffaella
authors.initials: R
authors.lastname: Scandellari
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fabris
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006918:Hydroxyurea / Q000009:adverse effects*; D007871:Leg Ulcer / Q000139:chemically induced*; D008297:Male; D009196:Myeloproliferative Disorders / Q000188:drug therapy*; D019384:Nucleic Acid Synthesis Inhibitors / Q000009:adverse effects*; D011087:Polycythemia Vera / Q000188:drug therapy; D013920:Thrombocythemia, Essential / Q000188:drug therapy; D013922:Thrombocytosis / Q000188:drug therapy
chemical_list: D019384:Nucleic Acid Synthesis Inhibitors; D006918:Hydroxyurea