Leg ulcers in patients with myeloproliferative disorders: disease- or treatment-related?

• Published in: Dermatology (Basel) Vol. 200; no. 1; p. 45
• Main Authors: Bader, U, Banyai, M, Böni, R, Burg, G, Hafner, J
• Format: Journal Article
• Language: English
• Published: Switzerland 2000
• Subjects: Aged; Aged, 80 and over; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Female; Follow-Up Studies; Humans; Hydroxyurea - adverse effects; Hydroxyurea - therapeutic use; Leg Ulcer - chemically induced; Male; Myeloproliferative Disorders - drug therapy; Polycythemia - drug therapy; Thrombocytosis - drug therapy
• ISSN: 1018-8665
• DOI: 10.1159/000018315

Leg ulcers are a relatively frequent problem in patients with myeloproliferative disorders under treatment with hydroxyurea (HU). The pathogenesis is currently unknown and may be multifactorial. Concomitant arterial or venous disease may play a contributing role in the development of these wounds. Vasculitis, cryoglobulinemia and pyoderma gangrenosum should be considered if typical clinical signs are present. We report on 3 patients with myeloproliferative disorders who developed HU-induced leg ulcers and review the literature. HU-induced leg ulcers share clinical features which can help to differentiate them from leg ulcers of other etiologies: occurrence under long-term treatment with HU at a dose of at least 1 g/day, localization in the malleolar region and spontaneous healing when HU is discontinued. We conclude that differentiation between disease-related and treatment-induced leg ulcers can be difficult and may not always be possible. In HU-induced leg ulcers, cessation of the drug typically leads to wound healing.