Leg ulcers in patients with myeloproliferative disorders: Disease- or treatment-related?

Leg ulcers are a relatively frequent problem in patients with myeloprolifer ative disorders under treatment with hydroxyurea (HU). The pathogenesis is currently unknown and may be multifactorial. Concomitant arterial or venous disease may play a contributing role in the development of these wounds. V asculitis, cryoglobulinemia and pyoderma gangrenosum should be considered i f typical clinical signs are present. We report on 3 patients with myelopro liferative disorders who developed HU-induced leg ulcers and review the lit erature. HU-induced leg ulcers share clinical features which can help to di fferentiate them from leg ulcers of other etiologies: occurrence under long -term treatment with HU at a dose of at least 1 g/day, localization in the malleolar region and spontaneous healing when HU is discontinued. We conclu de that differentiation between disease-related and treatment-induced leg u lcers can be difficult and may not always be possible. In HU-induced leg ul cers, cessation of the drug typically leads to wound healing. copyright (R) 2000 S. Karger AG, Basel.