Úlceras dolorosas múltiples en la pierna resistentes al tratamiento asociadas a lesiones dermatomiositis-like en las articulaciones interfalángicas de las manos: hidroxiurea como agente causal

Martorell-Calatayud, A.; Requena, Celia; Nagore-Enguídanos, E.; Guillén-Barona, C.

doi:10.1016/s0001-7310(09)72554-2

Cited by 13 publications

(5 citation statements)

References 14 publications

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“…Indeed, the ulcerations rarely respond to conventional optimal therapy [2,3,5,8,10,11]. They appear to be even refractory to surgical treatment if HU is not discontinued, as evidenced by a failed flap in the case reported by Tsuchiya et al [3] in 2010 as well as in our own experience with the third case.…”

Section: Discussionmentioning

confidence: 71%

“…The leg ulcers caused by HU typically occur on the lateral malleolar area and have been reported in approximately 9% of patients taking hhigher doses of HU for a period exceeding 1 year [3,10]. These extremely painful ulcers, although small and superficial, rarely heal if the medication is not withdrawn [3].…”

Section: Discussionmentioning

confidence: 99%

“…First, the thrombocytosis that is associated with ET, coupled to a poorly understood effect of HU on vessel endothelium and platelets, is likely to result in platelet thrombus with subsequent transient occlusion of microvessels [3]. Megaloblastosis (a known side effect of HU) has been postulated to play a role, too, as the enlarged red blood cells circulate less easily in small blood vessels [3,10]. Because it promotes cell death, HU can decrease keratinocyte viability, which in turn will hinder any re-epithelialization after the injury done by the above mechanisms.…”

Section: Discussionmentioning

confidence: 99%

“…Because it promotes cell death, HU can decrease keratinocyte viability, which in turn will hinder any re-epithelialization after the injury done by the above mechanisms. The effect is typically most visible on surfaces prone to mechanical trauma, such as the malleolar areas [3,10]. …”

Section: Discussionmentioning

confidence: 99%

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Successful Management of Hydroxyurea-induced Leg Ulcers in Essential Thrombocythemia: Report of 3 Cases

Rahal¹,

Ishak²,

Otrock³

et al. 2013

Tjh

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Essential thrombocythemia is one of the myeloproliferative neoplasms with a plethora of thrombohemorrhagic complications. Hydroxyurea has been proven to be an effective treatment for this condition. However, it is not without side effects. We herein report 3 patients with essential thrombocythemia treated with hydroxyurea who developed refractory leg ulcers, and we outline their successful management. We also review the literature to shed light on the mechanism of this toxicity. Awareness of this important treatment complication is important to avoid the pitfall of futile invasive interventions.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Successful Management of Hydroxyurea-induced Leg Ulcers in Essential Thrombocythemia: Report of 3 Cases

Rahal¹,

Ishak²,

Otrock³

et al. 2013

Tjh

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“…These ulcers are typically very painful and resolve spontaneously after withdrawal of the HU. 5 It is also known that HU is associated with the appearance of squamous cell carcinoma, which arises after a latency period of 2 to 13 years. These tumors are usually aggressive, and the treatment must be withdrawn.…”

mentioning

confidence: 99%

Dermatomyositis-Like Eruption Associated With Hydroxyurea Therapy: A Premalignant Condition?

Unamuno‐Bustos

Ballester‐Sánchez

Marco

et al. 2014

Actas Dermo-Sifiliográficas (English Edition)

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Symptomatic mucocutaneous toxicity of hydroxyurea in Philadelphia chromosome‐negative myeloproliferative neoplasms

Latagliata

Spadea

Cedrone³

et al. 2011

Cancer

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SMPC Ph1 neg BACKGROUND:The current study was conducted to evaluate severe mucocutaneous toxicity during treatment with hydroxyurea (HU) in a large cohort of patients with Philadelphia chromosome-negative myeloproliferative neoplasms (MPN). METHODS: Among 993 consecutive patients newly diagnosed with MPN at 4 centers in Rome between January 1980 and December 2009, 614 patients (277 men and 337 women with a median age of 64.4 years [interquartile range (IR), 54.4 years-72.7 years]) received HU. HU was administered as first-line treatment in 523 patients (85.2%) and as ! second-line treatment in 91 patients (14.8%). RESULTS: Mucocutaneous toxicity was reported in 51 patients (8.3%) after a median period from the initiation of HU treatment of 32.1 months (IR, 10.5 months-74.6 months) and a mean HU dose of 1085 mg (AE 390 mg); 30 patients (58.8%) developed a painful ulcerative skin toxicity, mainly located in the perimalleolar area; 11 patients (21.6%) had oral aphthous ulcers; and 10 patients (19.6%) developed a nonulcerative skin toxicity with erythema and skin infiltration. After the mucocutaneous toxicity occurred, HU treatment was continued at the same dose in 5 patients (9.8%), reduced in 12 patients (23.5%), and temporarily discontinued in 7 patients (13.7%); the remaining 27 patients (52.9%) required a permanent drug discontinuation. After a median period of 4.3 months (IR, 2.4 months-9.0 months) from the onset of the skin toxicity, 39 patients (76.5%) had a complete resolution and 12 patients (23.5%) had improvement without complete resolution. CONCLUSIONS: Mucocutaneous toxicity during HU treatment is more common than expected and may present with different clinical features. Moreover, it often requires a permanent drug discontinuation and only a partial resolution is reported to occur in approximately 25% of patients. Cancer 2012;118:404-

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Úlceras dolorosas múltiples en la pierna resistentes al tratamiento asociadas a lesiones dermatomiositis-like en las articulaciones interfalángicas de las manos: hidroxiurea como agente causal

Cited by 13 publications

References 14 publications

Successful Management of Hydroxyurea-induced Leg Ulcers in Essential Thrombocythemia: Report of 3 Cases

Successful Management of Hydroxyurea-induced Leg Ulcers in Essential Thrombocythemia: Report of 3 Cases

Dermatomyositis-Like Eruption Associated With Hydroxyurea Therapy: A Premalignant Condition?

Symptomatic mucocutaneous toxicity of hydroxyurea in Philadelphia chromosome‐negative myeloproliferative neoplasms

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