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        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">The onset of a dermatomyositis-like rash and persistent skin ulcers during long-term treatment with hydroxyurea is a very rare event that has not been fully described in the literature&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">The fact that these lesions have a typical clinical presentation and course&#44; and that complete resolution can only be achieved by immediate withdrawal of the drug&#44; means that dermatologists should be aware of this condition in order to avoid a delay in diagnosis&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">We present the case of a 76-year-old woman who developed a dermatomyositis-like eruption associated with chronic ulcers on the lower limbs during long-term treatment with hydroxyurea&#46;</p>"
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                    0 => array:2 [
                      "titulo" => "Secondary cutaneous effects of hydroxyurea&#58; possible pathogenetic mechanisms"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Zaccaria"
                            1 => "E&#46; Cozzani"
                            2 => "A&#46; Parodi"
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                        "tituloSerie" => "J Dermatolog Treat"
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                        "volumen" => "17"
                        "paginaInicial" => "176"
                        "paginaFinal" => "178"
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Leg ulcers and hydroxyurea&#58; forty-one cases"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;E&#46; Sirieix"
                            1 => "C&#46; Debure"
                            2 => "N&#46; Baudot"
                            3 => "L&#46; Dubertret"
                            4 => "M&#46;E&#46; Roux"
                            5 => "P&#46; Morel"
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                        ]
                      ]
                    ]
                  ]
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                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1999"
                        "volumen" => "135"
                        "paginaInicial" => "818"
                        "paginaFinal" => "820"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10411157"
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                          "autores" => array:4 [
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                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1998"
                        "volumen" => "138"
                        "paginaInicial" => "533"
                        "paginaFinal" => "535"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9580816"
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hydroxyurea dermopathy&#46; A unique lichenoid eruption complicating long-term therapy with hydroxyurea"
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                          "autores" => array:3 [
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                            2 => "M&#46;R&#46; Pittelkow"
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                        ]
                      ]
                    ]
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                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "1997"
                        "volumen" => "36"
                        "paginaInicial" => "178"
                        "paginaFinal" => "182"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9039164"
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                        "fecha" => "2008"
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                        "paginaInicial" => "872"
                        "paginaFinal" => "880"
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                    0 => array:2 [
                      "titulo" => "Unusual dermatologic toxicity of long-term therapy with hydroxyurea in chronic myelogenous leukemia"
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                          "etal" => false
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                        "tituloSerie" => "Tumori"
                        "fecha" => "1986"
                        "volumen" => "72"
                        "paginaInicial" => "317"
                        "paginaFinal" => "321"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3488611"
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                      "Revista" => array:6 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol"
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                        "paginaInicial" => "243"
                        "paginaFinal" => "244"
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                        "paginaFinal" => "874"
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                            3 => "J&#46; Briere"
                            4 => "F&#46; Cervantes"
                            5 => "G&#46; Finazzi"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/sj.leu.2404473"
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                        "tituloSerie" => "Leukemia"
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                        "paginaInicial" => "277"
                        "paginaFinal" => "280"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17251900"
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hydroxyurea-induced foot ulcer successfully treated with a topical basic fibroblast growth factor product"
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                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46; Aragane"
                            1 => "T&#46; Okamoto"
                            2 => "A&#46; Yajima"
                            3 => "R&#46; Isogai"
                            4 => "A&#46; Kawada"
                            5 => "T&#46; Tezuka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2003"
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                        "paginaInicial" => "599"
                        "paginaFinal" => "600"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12653764"
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                    0 => array:2 [
                      "titulo" => "Hydroxyurea-induced leg ulcers treated with a protease-modulating matrix"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Romanelli"
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                    0 => array:2 [
                      "doi" => "10.1001/archderm.143.10.1310"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "2007"
                        "volumen" => "143"
                        "paginaInicial" => "1310"
                        "paginaFinal" => "1313"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17938346"
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                    0 => array:2 [
                      "titulo" => "Successful healing of hydroxyurea-related leg ulcers with topical granulocyte-macrophage colony-stimulating factor"
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                          "etal" => false
                          "autores" => array:6 [
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                            2 => "U&#46; Consoli"
                            3 => "P&#46; Fiumara"
                            4 => "M&#46; Russo"
                            5 => "R&#46; Giustolisi"
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                        ]
                      ]
                    ]
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Journal Information
Vol. 100. Issue 9.
Pages 804-807 (November 2009)
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Vol. 100. Issue 9.
Pages 804-807 (November 2009)
Case reports
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Multiple Painful, Treatment-Resistant Leg Ulcers Associated With Dermatomyositis-Like Lesions Over the Interphalangeal Joints Induced by Hydroxyurea
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
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A. Martorell-Calatayud
Corresponding author
antmarto@hotmail.com

Correspondence: C/ San José de la Montaña n.° 14, puerta 11, 46008 Valencia, Spain.
, C. Requena, E. Nagore-Enguídanos, C. Guillén-Barona
Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain
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Article information
Abstract

The onset of a dermatomyositis-like rash and persistent skin ulcers during long-term treatment with hydroxyurea is a very rare event that has not been fully described in the literature.

The fact that these lesions have a typical clinical presentation and course, and that complete resolution can only be achieved by immediate withdrawal of the drug, means that dermatologists should be aware of this condition in order to avoid a delay in diagnosis.

We present the case of a 76-year-old woman who developed a dermatomyositis-like eruption associated with chronic ulcers on the lower limbs during long-term treatment with hydroxyurea.

Key words:
hydroxyurea
leg ulcer
dermatomyositis
Resumen

El desarrollo de una erupción dermatomiositis-like y de úlceras cutáneas de evolución tórpida, en el contexto de un tratamiento mantenido a largo plazo con hidroxiurea, es un fenómeno muy infrecuente y parcialmente descrito en la literatura.

El hecho de que las características clínicas y evolutivas de este tipo de lesiones son típicas y que su resolución completa sólo se alcanza mediante la suspensión inmediata del tratamiento, hace necesario que el dermatólogo conozca este cuadro, con el fin de evitar el retraso diagnóstico.

Presentamos el caso de una paciente de 76 años que desarrolló una erupción dermatomiositis-like junto a un proceso ulcerativo crónico en los miembros inferiores en el contexto de un tratamiento con hidroxiurea mantenido a largo plazo.

Palabras clave:
hidroxiurea
úlcera en pierna
dermatomiositis
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References
[1.]
E. Zaccaria, E. Cozzani, A. Parodi.
Secondary cutaneous effects of hydroxyurea: possible pathogenetic mechanisms.
J Dermatolog Treat, 17 (2006), pp. 176-178
[2.]
M.E. Sirieix, C. Debure, N. Baudot, L. Dubertret, M.E. Roux, P. Morel, et al.
Leg ulcers and hydroxyurea: forty-one cases.
Arch Dermatol, 135 (1999), pp. 818-820
[3.]
K. Wirth, E. Schoepf, R. Mertelsmann, A. Lindemann.
Leg ulceration with associated thrombocytosis: healing of ulceration associated with treatment of the raised platelet count.
Br J Dermatol, 138 (1998), pp. 533-535
[4.]
M.S. Daoud, L.E. Gibson, M.R. Pittelkow.
Hydroxyurea dermopathy. A unique lichenoid eruption complicating long-term therapy with hydroxyurea.
J Am Acad Dermatol, 36 (1997), pp. 178-182
[5.]
A.M. Seidler, A.B. Gottlieb.
Dermatomyositis induced by drug therapy: a review of case reports.
J Am Acad Dermatol, 59 (2008), pp. 872-880
[6.]
E. Montefusco, G. Alimena, R. Gastaldi, O.A. Carlesimo, G. Valesini, F. Mandelli.
Unusual dermatologic toxicity of long-term therapy with hydroxyurea in chronic myelogenous leukemia.
Tumori, 72 (1986), pp. 317-321
[7.]
A. Vélez, J.M. García-Aranda, J.C. Moreno.
Hydroxyureainduced leg ulcers: is macroerythrocytosis a pathogenic factor?.
J Eur Acad Dermatol Venereol, 12 (1999), pp. 243-244
[8.]
Z. Demirçay, A. Cömert, C. Adigüzel.
Leg ulcers and hydroxyurea: report of three cases with essential thrombocythemia.
Int J Dermatol, 41 (2002), pp. 872-874
[9.]
Guilabert-Vidal A, Iranzo-Fernandez P, Alsina Gibert M. Úlceras por hidroxiurea. Piel. 204;19:549-52.
[10.]
J.C. Moreno-Giménez, M. Galán-Gutiérrez, R. Jiménez-Puya.
Tratamiento de las úlceras crónicas.
Actas Dermosifiliogr, 96 (2005), pp. 133-146
[11.]
G. Barosi, C. Besses, G. Birgegard, J. Briere, F. Cervantes, G. Finazzi, et al.
A unified definition of clinical resistance/intolerance to hydroxyurea in essential thrombocytopenia: result of a consensus process by an international working group.
Leukemia, 21 (2007), pp. 277-280
[12.]
Y. Aragane, T. Okamoto, A. Yajima, R. Isogai, A. Kawada, T. Tezuka.
Hydroxyurea-induced foot ulcer successfully treated with a topical basic fibroblast growth factor product.
Br J Dermatol, 148 (2003), pp. 599-600
[13.]
M. Romanelli, V. Dini, P. Romanelli.
Hydroxyurea-induced leg ulcers treated with a protease-modulating matrix.
Arch Dermatol, 143 (2007), pp. 1310-1313
[14.]
F. Stagno, P. Guglielmo, U. Consoli, P. Fiumara, M. Russo, R. Giustolisi.
Successful healing of hydroxyurea-related leg ulcers with topical granulocyte-macrophage colony-stimulating factor.
Blood, 94 (1999), pp. 1479-1480
Copyright © 2009. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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