Advanced International Journal for Research

E-ISSN: 3048-7641   •   Impact Factor: 9.11

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Hydroxyurea-Induced Non-Healing Leg Ulcer in Essential Thrombocythemia: A Case Report

Author(s) Dr Aman Kumar
Country India
Abstract Hydroxyurea is a first-line cytoreductive agent for high-risk essential thrombocythemia (ET) due to its efficacy in reducing thrombotic events. Although generally well tolerated, long-term use may lead to rare cutaneous complications, notably non-healing leg ulcers. We report the case of a 52-year-old female with triple-negative ET who developed a painful ulcer above the left lateral malleolus after three years of hydroxyurea therapy. Initial evaluation, including venous Doppler, ruled out vascular pathology. Despite standard wound management, the ulcer progressed, prompting suspicion of a drug-induced etiology. Hydroxyurea was discontinued, and anagrelide was initiated, resulting in complete ulcer healing within three months. Hydroxyurea-induced ulcers are thought to result from cytotoxic damage to keratinocytes and endothelial cells, impairing microvascular function and delaying healing. Clinicians should maintain a high index of suspicion for drug-induced ulcers in ET patients on long-term hydroxyurea therapy to avoid unnecessary interventions. Early withdrawal of hydroxyurea and initiation of alternative agents such as anagrelide can ensure favorable outcomes.
Keywords Hydroxyurea, Essential thrombocythemia, Non-healing ulcer, Leg ulcer, Anagrelide, Drug-induced skin injury
Field Medical / Pharmacy
Published In Volume 6, Issue 4, July-August 2025
Published On 2025-08-19
DOI https://doi.org/10.63363/aijfr.2025.v06i04.1118
Short DOI https://doi.org/g9zzbx
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E-ISSN 3048-7641
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