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Skin and nail changes in children with sickle cell anemia receiving hydroxyurea therapy
E E O'branski1, R E Ware, N S Prose
1Duke University Pediatric Sickle Cell Program and Division of Hematology/Oncology, Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA.
Insights
Hydroxyurea therapy can cause skin and nail changes in children with sickle cell anemia. These changes, including hyperpigmentation, may appear after weeks of treatment.
Area of Science:
- Pediatric Hematology
- Dermatology
- Pharmacology
Background:
- Hydroxyurea is a medication used to treat sickle cell anemia.
- Long-term hydroxyurea therapy in adults is associated with cutaneous side effects.
- The effects of hydroxyurea on pediatric patients require further investigation.
Observation:
- Seven pediatric patients with sickle cell anemia were treated with hydroxyurea.
- Skin and nail changes were observed in these children.
- Changes included nail hyperpigmentation, longitudinal nail bands, and palmar hyperpigmentation.
Findings:
- Cutaneous and nail changes developed in children receiving hydroxyurea therapy.
- Onset of these changes occurred within 6 to 16 weeks of treatment.
- The observed changes are consistent with known side effects of hydroxyurea.
Implications:
- Clinicians should monitor children with sickle cell anemia for skin and nail changes during hydroxyurea therapy.
- Early recognition of these side effects can guide treatment adjustments.
- Understanding pediatric-specific side effect profiles is crucial for safe and effective sickle cell disease management.
Abstract:
Skin and nail changes from long-term hydroxyurea therapy are reported in adults. Skin and nail changes, including nail hyperpigmentation, longitudinal bands, and hyperpigmentation of the palms and other skin surfaces, developed in 7 children with sickle cell anemia after 6 to 16 weeks of hydroxyurea therapy. Cutaneous and nail changes may occur in children receiving hydroxyurea.