Ulzerationen unter Therapie mit Hydroxyharnstoff

Abstract

Hydroxyurea is frequently used for therapy of myeloproliferative disorders. One cutaneous side-effect is painful, therapy-resistant ulcers which have bizarre configurations and occur at atypical sites for venous ulcers. Improvement or healing often first occurs when hydroxyurea is discontinued. We report on one patient with essential thrombocythemia and two with polycythemia vera, who developed such ulcers during hydroxyurea therapy. In one case, the ulcers developed shortly after hydroxyurea was started. In addition we give a short overview of the current literature.

Hydroxyurea Associated Cutaneous Lesions: A Case Report

“…Multiple publications show similarities to our case regarding the proposed aetiology of the leg ulcer. Consistently, dosage and duration of HU administration, as well as the location of the ulcer and the progression of the lesion: long-term use of HU (> 5 years), (1 or 1.5 mg per day), very painful perimalleolar ulcers, with no prior trauma [ 5 ] [ 11 ] [ 12 ] [ 13 ] [ 14 ]. Notwithstanding the standard wound therapy, treatment of choice in HU-induced leg ulcers is discontinuation of the drug or substitution therapy [ 8 ].…”

“…Notwithstanding the standard wound therapy, treatment of choice in HU-induced leg ulcers is discontinuation of the drug or substitution therapy [ 8 ]. In contrast, there were few cases, where only standard debridement therapy, without discontinuation of HU, was enough to achieve successful partial or complete remission of the ulcers [ 6 ] [ 11 ] [ 13 ]. Correspondingly to some publications [ 6 ] [ 13 ] [ 14 ], our case showed refraction to standard conservative therapy.…”

“…In contrast, there were few cases, where only standard debridement therapy, without discontinuation of HU, was enough to achieve successful partial or complete remission of the ulcers [ 6 ] [ 11 ] [ 13 ]. Correspondingly to some publications [ 6 ] [ 13 ] [ 14 ], our case showed refraction to standard conservative therapy. Hence a consultation with a haematologist for discontinuation and substituting it with recommended second-line therapy with pegylated IFN-α was commenced [ 4 ].…”