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

Dermatology. 2000;200(1):45-8. doi: 10.1159/000018315.


Leg ulcers are a relatively frequent problem in patients with myeloproliferative 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. Vasculitis, cryoglobulinemia and pyoderma gangrenosum should be considered if typical clinical signs are present. We report on 3 patients with myeloproliferative disorders who developed HU-induced leg ulcers and review the literature. HU-induced leg ulcers share clinical features which can help to differentiate 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 conclude that differentiation between disease-related and treatment-induced leg ulcers can be difficult and may not always be possible. In HU-induced leg ulcers, cessation of the drug typically leads to wound healing.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Hydroxyurea / adverse effects*
  • Hydroxyurea / therapeutic use
  • Leg Ulcer / chemically induced*
  • Male
  • Myeloproliferative Disorders / drug therapy*
  • Polycythemia / drug therapy
  • Thrombocytosis / drug therapy


  • Antineoplastic Agents
  • Hydroxyurea