title: Hydroxyurea-induced leg ulcers treated with a protease-modulating matrix.
abstract: BACKGROUND
  The development of painful leg ulcers in the ankle area is a rare and only partially described complication in patients receiving high-dose, long-term hydroxyurea treatment for myeloproliferative diseases. Several reports have described treatments for chronic wound management with this type of lesion.
  
  
  METHODS
  We describe 2 patients who were diagnosed as having hydroxyurea-induced leg ulcers that were successfully treated with a freeze-dried sponge containing oxidized regenerated cellulose and bovine purified collagen. This dressing is able to modulate the activity of proteases such as plasmin, neutrophil-derived elastase, and matrix metalloproteinase by physically entrapping them and thus inhibiting their activity.
  
  
  CONCLUSIONS
  This case demonstrates that topical application of a matrix metalloproteinase modulator can be a successful and safe treatment option for patients with hydroxyurea-induced recalcitrant leg ulcers.
authors.affiliation: Department of Dermatology, University of Pisa, Pisa, Italy. m.romanelli@med.unipi.it
authors.forename: Marco
authors.initials: M
authors.lastname: Romanelli
authors.forename: Valentina
authors.initials: V
authors.lastname: Dini
authors.forename: Paolo
authors.initials: P
authors.lastname: Romanelli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D047070:Bandages, Hydrocolloid; D002417:Cattle; D002483:Cellulose, Oxidized / Q000627:therapeutic use*; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006918:Hydroxyurea / Q000009:adverse effects* / Q000627:therapeutic use; D007871:Leg Ulcer / Q000139:chemically induced / Q000473:pathology / Q000628:therapy*; D019384:Nucleic Acid Synthesis Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011087:Polycythemia Vera / Q000188:drug therapy; D011480:Protease Inhibitors / Q000627:therapeutic use*; D013922:Thrombocytosis / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D002483:Cellulose, Oxidized; D019384:Nucleic Acid Synthesis Inhibitors; D011480:Protease Inhibitors; D003094:Collagen; D006918:Hydroxyurea