Efeitos colaterais cutâneos após uso prolongado de hidroxiuréia na Policitemia Vera

Abstract

Abstract:Hydroxyurea is an hydroxylated urea derivative used in many myeloproliferative disorders. Many, but unusual cutaneous disorders are related after its prolonged use. Their pathogenesis is not clear, but it is suggested that there is direct toxicity of the drug on the skin. We described a white, 75-year old man with diagnosis of Polycythemia Vera that in 11 years of treatment developed many cutaneous lesions: skin hyperpigmentation, atrophic lesions on forearms, longitudinal melanonychia of 20 nails, right forearm ulcer, cutaneous xerosis, ichthyosis and auricular spinocellular carcinoma. At this moment, the literature reports describe little diversity of lesions in affected patients. Keywords: Hydroxyurea; Polycythemia vera; Skin manifestations Resumo: A hidroxiureia é um derivado hidroxilado da ureia utilizado em diversas desordens hematológi-cas. Inúmeras alterações cutâneas, porém raras, são relatadas após seu uso prolongado. A patogênese das mesmas não está bem esclarecida, porém, sugere-se que a droga tenha uma ação tóxica direta sobre a pele. Descrevemos um homem de 75 anos, branco, com diagnóstico de Policitemia Vera que, ao longo de 11 anos de tratamento com hidroxiureia, evoluiu com várias lesões cutâneas: hiperpigmentação da pele, lesões atró-ficas em antebraços, melanoníquia longitudinal das 20 unhas, úlcera em antebraço direito, xerose cutânea, ictiose em pernas e carcinoma espinocelular no pavilhão auricular direito. Até o momento, os relatos na literatura descrevem pouca diversidade de lesões nos pacientes acometidos.

Squamous Cell Carcinoma as a Complication of Long-Term Hydroxyurea Treatment

“…Long-term follow-up of patients treated with HU is mandatory because recurrence of the NMSC tumor may occur several years after HU discontinuation. We did not observe any changes in the nails in our case; however, the literature describes cases of patients who developed melanonychia during HU therapy [7, 8]. There are no recommendations regarding the chemoprevention of NMSC in the population treated with HU [8].…”

“…We did not observe any changes in the nails in our case; however, the literature describes cases of patients who developed melanonychia during HU therapy [7, 8]. There are no recommendations regarding the chemoprevention of NMSC in the population treated with HU [8]. However, some studies show that chemoprevention with oral retinoids can reduce the risk of development of SCC both in moderate-risk and high-risk patients [9, 10].…”

“…The aim of the case is also to draw the clinicians' attention to the increased risk of squamous cell carcinoma and basal cell carcinoma in patients treated with HU. Long-term follow-up of patients treated with HU might be recommended [ 8 ], and it would make it possible to recognize NMSC earlier, and thus potentially reduce the undesirable effects associated with the delayed radical treatment of these skin cancers.…”

Intervenções Farmacêuticas Realizadas Nos Pacientes Com Anemia Falciforme Acompanhados No Hemocentro Da Paraíba, Brasil (2015-2016)/ Pharmacuetical Interventions in Patients With Sickle Cell Anemia Treated in the Paraiba Hemocenter, Brazil (2015-2016)

“…Esse medicamento diminui as crises, reduz o número de internações, reduz a mortalidade e melhora a qualidade de vida dos portadores da doença 4,17,24 25 relatou um caso de um homem de 75 anos, branco, com diagnostico de Policitemia Vera que, ao longo de 11 anos de tratamento com hidroxiuréia, evoluiu com várias lesões cutâneas como: hiperpigmentação da pele, lesões atróficas em antebraços dentre outras. Todas essas manifestações clínicas melhoraram consideravelmente após suspensão da droga.…”

Laser Photobiomodulation for a Complex Patient with Severe Hydroxyurea-Induced Oral Ulcerations

“…On the other hand, skin and mucosal side effects are not completely understood and usually occur following long-term therapy; cutaneous abnormalities include xerosis, ichthyosiform lesions, dark brown pigmentation of skin folds and nails, and malleolar ulcers as well as malignant tumors [8–10]. …”