Hydroxyurea Ulcers of Unusual Location: A Case Report and Review of the Literature

Abstract

Abstract Introduction Hydroxyurea is a cytotoxic drug that has been used for decades for the treatment of various entities, mostly hematological, especially polycythemia vera. Its side effects are varied, including dermatological ones, ranging from skin xerosis, hyperpigmentation, lesions like dermatomyositis, and even a relationship with premalignant processes (actinic keratosis) and non-melanoma cancer (squamous, basal cell, Merkel, and oral tumors). Case presentation In this paper, we report a clinical case of a relatively frequent adverse effect of hydroxyurea, ulcers, but of extraordinary localization and clinical presentation. Specifically, in our patient, the location was both hands, associated dermatomyositis-like lesions and nail hyperpigmentation, skin changes also related to hydroxyurea. The therapeutic response with withdrawal was spectacular. Conclusions The association of ulcers with taking hydroxyurea is well known. Most of the time, these appear in the lower limbs, and in patients with chronic vascular pathology. However, in some patients in some patients, it can present atypically. Knowledge of this condition is vitally important for the hematologist and the dermatologist to ensure adequate care.