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Phlebologie 2004; 33(06): 202-205
DOI: 10.1055/s-0037-1621559
Original Article
Schattauer GmbH

Cutaneous ulcers following hydroxyurea therapy

Hautulzerationen nach HydroxycarbamidUlcères cutanés consécutifs au traitement par hydroxycarbamide
K. Hartmann
1   Department of Dermatology, University of Bonn, Germany
,
S. Nagel
1   Department of Dermatology, University of Bonn, Germany
,
T. Erichsen
1   Department of Dermatology, University of Bonn, Germany
,
E. Rabe
1   Department of Dermatology, University of Bonn, Germany
,
K. H. Grips
1   Department of Dermatology, University of Bonn, Germany
,
T. Bieber
1   Department of Dermatology, University of Bonn, Germany
,
F. Pannier-Fischer
1   Department of Dermatology, University of Bonn, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
04 January 2018 (online)

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Summary

Hydroxyurea (HU) is usually a well tolerated antineoplastic agent and is commonly used in the treatment of chronic myeloproliferative diseases. Dermatological side effects are frequently seen in patients receiving longterm HU therapy. Cutaneous ulcers have been reported occasionally.

We report on four patients with cutaneous ulcers whilst on long-term hydroxyurea therapy for myeloproliferative diseases. In all patients we were able to reduce the dose, or stop HU altogether and their ulcers markedly improved. Our observations suggest that cutaneous ulcers should be considered as possible side effect of long-term HU therapy and healing of the ulcers can be achieved not only by cessation of the HU treatment, but also by reducing the dose of hydroxyurea for a limited time.

Zusammenfassung

Hydroxycarbamid ist ein häufig verwendeter, gut verträglicher Wirkstoff in der Behandlung chronisch myeloproliferativer Erkrankungen. Dermatologische Nebenwirkungen werden des Öfteren bei Patienten mit einer Hydroxycarbamid-Langzeitbehandlung beobachtet. Hautulzerationen wurden vereinzelt beschrieben. Wir berichten über vier Patienten mit Hautulzerationen unter Hydroxycarbamidtherapie. Bei allen Patienten konnten wir die Hydroxycarbamiddosis reduzieren oder vollständig absetzen und es kam zur Besserung der Hautulzerationen. Unsere Beobachtungen zeigen, dass Hautulzerationen als unerwünschte Arznzeimittelwirkung einer Langzeitbehandlung mit Hydroxycarbamid auftreten können und dass eine Abheilung der Ulzerationen nicht nur durch Absetzen von Hydroxycarbamid, sondern auch durch kurzzeitige Dosisreduktion erreicht werden kann.

Résumé

L’hydroxycarbamide est un principe actif bien toléré et est fréquemment utilisé pour le traitement des maladies myéloprolifératives chroniques. Des effets secondaires dermatologiques surviennent fréquemment chez des patients soumis à un traitement par hydroxycarbamide au long cours. Quelques cas d’ulcères cutanés ont été décrits ponctuellement.

Nous rapportons quatre cas de patients présentant des ulcères cutanés durant un traitement au long cours d’hydroxycarbamide. Chez tous les patients la dose d’hydroxycarbamide a pu être réduite ou le traitement arrêté, ce qui permit une nette amélioration des ulcères cutanés. Nos observations montrent que des ulcères cutanés peuvent apparaître comme effet secondaire d’un traitement au long cours par hydroxycarbamide et qu’une guérison de ces ulcères est possible, non seulement en interrompant le traitement par hydroxycarbamide, mais aussi en diminuant transitoirement la dose d’hydroxycarbamide.

Keywords

Hydroxyurea - ulcer - myeloproliferative disease - interferon

Schlüsselwörter

Hydroxycarbamid - Ulkus - myeloproliferative Erkrankung - Interferon

Mots clés

Hydroxycarbamide - ulcère - maladie myéloproliférative - interféron
 

  • References

  • 1 Best PJ, Daoud MS, Pittelkow MR. et al. Hydroxyurea-induced leg ulceration in 14 patients. Ann Int Med 1998; 128: 29-32.
    CrossrefPubMedGoogle Scholar
  • 2 Bohn J, Hansen J, Menne T. Ulcerative lichen planus-like dermatitis due to long-term hydroxyurea therapy for chronic myelogenous leukemia. J Eur Acad Dermatol Venereol 1998; 10: 187-9.
    PubMedGoogle Scholar
  • 3 Boyd AS, Neldner KH. Hydroxyurea therapy. J Am Acad Dermatol 1991; 25: 518-24.
    CrossrefPubMedGoogle Scholar
  • 4 Chaine B, Neonato MG, Girot R. et al. Cutaneous adverse reactions to hydroxyurea in patients with sickle cell disease. Arch Dermatol 2001; 137: 467-70.
    PubMedGoogle Scholar
  • 5 Daoud MS, Gibson LE, Pittelkow MR. Hydroxyurea dermopathy: a unique lichenoid eruption complicating long-term therapy with hydroxyurea. J Am Acad Dermatol 1997; 36: 178-82.
    CrossrefPubMedGoogle Scholar
  • 6 Demircay Z, Cömert A, Adlgüzel C. Leg ulcers and hydroxyurea: report or three cases with essential thrombocythemia. Int J Dermatol 2002; 41: 872-4.
    CrossrefPubMedGoogle Scholar
  • 7 Kennedy BJ, Smith LR, Goltz RW. Skin changes secondary to hydroxyurea therapy. Arch Dermatol 1975; 111: 183-7.
    CrossrefPubMedGoogle Scholar
  • 8 Montefusco E, Alimena G, Gastaldi R. et al. Unusual dermatologic toxicity of long-term therapy with hydroxyurea in chronic myelogenous leukemia. Tumori 1986; 72: 317-21.
    PubMedGoogle Scholar
  • 9 Ravandi-Kashani F, Cortes J, Cohen P. et al. Cutaneous ulcers associated with hydroxyurea therapy in myeloproliferative disorders. Leuk Lymphoma 1999; 35: 109-18.
    CrossrefPubMedGoogle Scholar
  • 10 Sirieix ME, Debure C, Baudot N. et al. Leg ulcers and hydroxyurea: forty-one cases. Arch Dermatol 1999; 135: 818-20.
    PubMedGoogle Scholar
  • 11 Stagno F, Guglielmo P, Consoli U. et al. Successful healing of hydroxyurea-related leg ulcers with topical granulocyte-macrophage-colonystimulating factor. Blood 1999; 94: 1479-80.
    PubMedGoogle Scholar
  • 12 Weinlich G, Schuler G, Greil R. et al. Leg ulcers associated with long-term hydroxyurea therapy. J Am Acad Dermatol 1998; 39: 372-4.
    CrossrefPubMedGoogle Scholar
  • 13 Yarbro JW. Mechanism of action of hydroxyurea. Semin Oncol 1992; 19: 1-10.
    PubMedGoogle Scholar