Leg Ulcer in Patient with Sickle Cell Disease on Hydroxyurea
DOI:
https://doi.org/10.17140/IMOJ-4-114Keywords:
Leg Ulcer, Sickle cell disease (SCD), HydroxyureaAbstract
Leg ulcers are a painful side-effect commonly seen in patients with long-term use of hydroxyurea. We describe an ulcer in a patient with sickle cell disease (SCD) with an 8-year history of hydroxyurea use. Wound care team used cadexomer-iodine topical and collagenase to aid in healing. There are limited options for the treatment of these ulcers beside the cessation of hydroxyurea, a very effective drug in reducing painful sickle cell episodes. It is imperative to be aware of this complication to prevent expensive tests and further work up. Future study into alternative treatment of hydroxyurea-induced leg ulcers for sickle cell patients is necessary.
References
Chakravorty S, Williams TN. Sickle cell disease: A neglected chronic disease of increasing global health importance. Arch Dis Child. 2015; 100(1): 48-53. doi: 10.1136/archdischild-2013-303773
Strouse JJ, Heeney MM. Hydroxyurea for the treatment of sickle cell disease: Efficacy, barriers, toxicity, and management in children. Pediatr Blood Cancer. 2012; 59(2): 365-371. doi: 10.1002/pbc.24178 Case Report | Volume 4 | Number 1|
Agrawal RK, Patel RK, Nainiwal L, Trivedi B. Hydroxyurea in sickle cell disease: Drug review. Indian J Hematol Blood Transfus. 2014; 30(2): 91-96. doi: 10.1007/s12288-013-0261-4
Ault A. US FDA approves first drug for sickle-cell anaemia. The Lancet. 1998; 351(9105): 809. doi: 10.1016/S0140-6736(05)78941-8
Cokic VP, Smith RD, Beleslin-Cokic BB, Njoroge JM, Miller JL, Gladwin MT, et al. Hydroxyurea induces fetal hemoglobin by the nitric oxide–dependent activation of soluble guanylyl cyclase. J. Clin. 2003 Jan 15;111(2):231-239. doi: 10.1172/JCI16672
Quattrone F, Dini V, Barbanera S, Zerbinati N, Romanelli M. Cutaneous ulcers associated with hydroxyurea therapy. J Tissue Vi-ability. 2013; 22(4): 112-121. doi: 10.1016/j.jtv.2013.08.002
Romanelli M, Dini V, Romanelli P. Hydroxyurea-induced leg ulcers treated with a protease-modulating matrix. Arch Dermatol. 2007; 143(10): 1310-1313. doi: 10.1001/archderm.143.10.1310
Brawley OW, Cornelius LJ, Edwards LR, Gamble VN, Green BL, Inturrisi C, et al. National Institutes of Health Consensus Development Conference statement: Hydroxyurea treatment for sickle cell disease. Ann Intern Med. 2008; 148(12): 932-938. doi: 10.7326/0003-4819-148-12-200806170-00220
Sirieix ME, Debure C, Baudot N, Dubertret L, Roux ME, Morel Submit your article to this journal | https://openventio.org/submit-manuscript/ Case Report | Volume 4 | Number 1| Nutan F et al P, et al. Leg ulcers and hydroxyurea: Forty-one cases. Arch Dermatol. 1999; 135(7): 818-820. doi: 10.1001/archderm.135.7.818
Singh A, Xu YJ. The Cell killing mechanisms of hydroxyurea. Genes (Basel). 2016; 7(11): 99. doi: 10.3390/genes7110099
Rahal JA, Ishak RS, Otrock ZK, Maakaron JE, Ghosn S, Ta-her AT. Successful management of hydroxyurea-induced leg ulcers in essential thrombocythemia: Report of 3 cases. Turk J Haematol. 2013; 30(2): 184-187. doi: 10.4274/Tjh.2012.0134
Boyd AS, Neldner KH. Hydroxyurea therapy. J Am Acad Der-matol. 1991; 25(3): 518-524. doi: 10.1016/0190-9622(91)70233-r
Minniti CP, Eckman J, Sebastiani P, Steinberg MH, Ballas SK. Leg ulcers in sickle cell disease. Am J Hematol. 2010; 85(10): 831- 833. doi: 10.1002/ajh.21838
Akinci B, Yesil S, Atabey A, Ilgezdi S. Hydroxyurea associated leg ulcer succesfully treated with hyperbaric oxygen in a diabetic patient. Exp Clin Endocrinol Diabetes. 2007; 115(02): 143-145. doi: 10.1055/s-2007-956164
Méry L, Girot R, Aractingi S. Topical effectiveness of mol-gramostim (GM-CSF) in sickle cell leg ulcers. Dermatology. 2004; 208(2): 135-137. doi: 10.1159/000076487
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