ATROPHIC COLLODION SKIN IN LONG-TERM TREA TMENT WITH HYDROXYUREA

Introduction: Despite good general and hematological tolerance, hydrox yurea frequently causes polymorphous skin lesions when given as long-t erm therapy. Distal skin atrophy, pseudodermatomyositis, pseudolichen and ulcerations have been observed. Cas report: We report three cases of diffuse atrophic collodion skin in patients given long-term hydroxy urea. Histology findings demonstrated atrophy and the same signs locat ed at the dermo-epidermal junction as seen in acute toxidermia due to hydroxyurea. Examination of the ultrastructure showed abnormalities in the proliferative epidermal layer which was disrupted by edema and a multiple, irregular basal membrane. Discussion: The chronology of the lesions and partial resolution after treatment withdrawal together wit h clinical and histological signs demonstrating hydroxyurea impregnati on would implicate hydroxyurea as the cause of this case of diffuse at rophic collodion skin. Cells in the epidermal layer of the skin, the m ost external layer in the organism, have a high turnover rate and woul d be more vulnerable to the cytostatic action of hydroxyurea than othe r tissues. The effect of hydroxyurea on keratinocytes implicated in th e production and maintenance of the basal membrane would be one of the causes.