Kutane Nebenwirkungen einer Hydroxyurea-Therapie bei Polycythaemia vera

Hoff, Norman-Philipp; Akanay-Diesel, S.; Pippirs, U.; Schulte, K.-W.; Hanneken, S.

doi:10.1007/s00105-009-1844-8

Cited by 12 publications

(6 citation statements)

References 7 publications

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“…It's supposed that, while tacking hydroxyurea, UV radiation provides an ideal environment for the formation of cSCC. In addition, HU can markedly elevate p53 levels in basal layer keratinocytes, which increases the risk of skin cancers; it also inhibits DNA synthesis and DNA repair in ultraviolet-irradiated human cells, interfering with cell replication in the basal layer of the epidermis [12] , [13] , [14] , [15] , [16] . This pathogenic mechanism could explain the appearance of the lesion on the face which is a photo exposed skin [17] .…”

Section: Discussionmentioning

confidence: 99%

Squamous cell carcinoma during long term hydroxyurea treatment: A case report

Kerdoud¹,

Aloua²,

Kaouani³

et al. 2021

International Journal of Surgery Case Reports

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Background Hydroxyurea (HU) is a ribonucleotide diphosphate reductase inhibitor that interferes with the S phase of cell replication and inhibits DNA synthesis, with limited or no effect on RNA or protein synthesis. The cutaneous side effects of hydroxyurea treatment are diverse and frequent. Squamous cell carcinoma is one of the most challenging side-effect. Case presentation The authors report the case of a healthy 59-year-old woman on long-term therapy with Hydroxyurea 500 mg daily for essential thrombocytosis, presented with a painless slow-growing lesion of the jaw that had persisted and increased in size for six months, the appearance of the lesion is correlated to the administration of the hydroxyurea treatment. Clinical examination revealed a large nodular lesion 4 × 4 cm with irregular borders of the right cheek, infiltrated into underlying tissue, the lesion extending to the free border of the right lower eyelid without sensory disturbances or diplopia. The surgery was indicated. The surgical procedure had the aim of the restoration of the anatomic landmarks after a large excision of the tumor and reconstruction of full-thickness eyelid defect with a local flap under general anesthesia. Conclusion Maxillofacial surgeons must be aware of the side effects of hydroxyurea including facial cancer, ulceration, etc. Rigorous follow-up of patients on hydroxyurea is required.

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Section: Discussionmentioning

confidence: 99%

Squamous cell carcinoma during long term hydroxyurea treatment: A case report

Kerdoud¹,

Aloua²,

Kaouani³

et al. 2021

International Journal of Surgery Case Reports

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“…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 ].…”

Section: Discussionmentioning

confidence: 99%

Hydroxyurea Associated Cutaneous Lesions: A Case Report

Simeonovski

Breshkovska

Duma

et al. 2018

Open Access Maced J Med Sci

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BACKGROUND:Hydroxyurea (HU) is an antimetabolite agent that interferes with the S-phase of cellular replication and inhibits DNA synthesis, with little or no effect on RNA or protein synthesis. It is used in the treatment of many myeloproliferative disorders (MD) and is particularly a first line treatment drug for intermediate to high-risk essential thrombocythemia. Although safe and very well tolerated by the patients suffering from MD, there have been numerous reports of a broad palette of cutaneous side effects associated with prolonged intake of the medication. These may include classical symptoms such as xerosis, diffuse hyperpigmentation, brown-nail discolouration, stomatitis and scaling of the face, hands, and feet or more serious side effects such as actinic keratosis lesions, leg ulcers and multiple skin carcinomas.CASE REPORT:We report a case of a 52-year-old man, on long-term therapy with HU for essential thrombocytosis, with several concurrent skin lesions. Despite the perennial use of HU, the cutaneous changes were neglected. The local dermatological examination revealed oval perimalleolar ulcer on the right leg, with dimensions 6 x 4 cm, clearly demarcated from the surroundings with regular margins, periulcerous erythema, with very deep and highly fibrinous bed of the ulcer, positive for bacterial infection. The ulcer was treated with topical wound therapy with alginate and parenteral antibiotics. The extended dermatological screening also showed two nummular lesions in the right brachial region, presenting as erythematous papules with sharp margins from the surrounding skin, gritty desquamation and dotted hyperpigmentations inside the lesion. Further dermoscopy and biopsy investigations confirmed a diagnosis of basal cell carcinoma. Nasal actinic keratosis was also noted. The patient was advised for discontinuing or substituting the HU therapy.CONCLUSION:We present this case to draw attention to the various cutaneous side effects that occur with perennial HU use and suggest an obligatory reference to a dermatological consult.

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“…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]. …”

Section: Discussionmentioning

confidence: 99%

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

Cabras

Cafaro

Gambino

et al. 2016

Case Reports in Dentistry

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Patients affected by polycythemia vera (PV), a myeloproliferative neoplasm characterized by an elevated red blood cell mass, are at high risk of vascular and thrombotic complications. Conventional therapeutic options aim at reducing vascular and thrombotic risk; low-dose aspirin and phlebotomy are first-line recommendations, for patients at low risk of thrombotic events, whereas cytoreductive therapy, usually hydroxyurea (HU) or interferon alpha, is recommended for high-risk patients. In the present study, we report the case of a patient with persistent oral ulcerations, possibly related to long-lasting HU treatment, firstly treated with topic and systemic corticosteroids and then more effectively with the addition of low-level laser therapy. Laser photobiomodulation has achieved pain control and has contributed to the healing of oral ulcers without any adverse effect; this has permitted a reduction in the dose of systemic corticosteroids and the suspension of the use of the topic ones, due to the long-term stability of oral health, even after the interruption of low-level laser therapy sessions.

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Kutane Nebenwirkungen einer Hydroxyurea-Therapie bei Polycythaemia vera

Cited by 12 publications

References 7 publications

Squamous cell carcinoma during long term hydroxyurea treatment: A case report

Squamous cell carcinoma during long term hydroxyurea treatment: A case report

Hydroxyurea Associated Cutaneous Lesions: A Case Report

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

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