Hydroxyurea-induced leg ulceration in 14 patients

Background: Hydroxyurea is an antineoplastic agent commonly used to treat myeloproliferative disorders and other nonneoplastic conditions. Objective: To further define the typical features of hydroxyurea-related cutaneous ulcers of the leg. Design: Retrospective, descriptive study of the medical records of patients who developed leg ulcers while receiving hydroxyurea therapy. Setting: A tertiary care medical center. Patients: Patients with myeloproliferative disorders who were treated with hydroxyurea. Results: 14 patients with extremely painful leg ulcers were identified. The most common ulcer site was the malleoli. Multiple ulcers were seen in 64% of patients. Patients had received hydroxyurea for an average of 6 years before ulcers developed. All ulcers healed after discontinuation of hydroxyurea treatment, and 2 patients developed ulcers after treatment was restarted. Conclusion: Hydroxyurea induces painful leg ulcers that are usually difficult to treat and require cessation of hydroxyurea therapy.