Hydroxyurea-induced leg ulcers treated with a protease-modulating matrix

Arch Dermatol. 2007 Oct;143(10):1310-3. doi: 10.1001/archderm.143.10.1310.

Abstract

Background: The development of painful leg ulcers in the ankle area is a rare and only partially described complication in patients receiving high-dose, long-term hydroxyurea treatment for myeloproliferative diseases. Several reports have described treatments for chronic wound management with this type of lesion.

Observations: We describe 2 patients who were diagnosed as having hydroxyurea-induced leg ulcers that were successfully treated with a freeze-dried sponge containing oxidized regenerated cellulose and bovine purified collagen. This dressing is able to modulate the activity of proteases such as plasmin, neutrophil-derived elastase, and matrix metalloproteinase by physically entrapping them and thus inhibiting their activity.

Conclusion: This case demonstrates that topical application of a matrix metalloproteinase modulator can be a successful and safe treatment option for patients with hydroxyurea-induced recalcitrant leg ulcers.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Animals
  • Bandages, Hydrocolloid*
  • Cattle
  • Cellulose, Oxidized / therapeutic use*
  • Collagen / therapeutic use*
  • Female
  • Humans
  • Hydroxyurea / adverse effects*
  • Hydroxyurea / therapeutic use
  • Leg Ulcer / chemically induced
  • Leg Ulcer / pathology
  • Leg Ulcer / therapy*
  • Nucleic Acid Synthesis Inhibitors / adverse effects*
  • Nucleic Acid Synthesis Inhibitors / therapeutic use
  • Polycythemia Vera / drug therapy
  • Protease Inhibitors / therapeutic use*
  • Thrombocytosis / drug therapy
  • Treatment Outcome

Substances

  • Cellulose, Oxidized
  • Nucleic Acid Synthesis Inhibitors
  • Protease Inhibitors
  • Collagen
  • Hydroxyurea