[Multiple skin and mouth squamous cell carcinomas related to long-term treatment with hydroxyurea]

Cutaneous side-effects of hydroxyurea treatment are frequently observed. Squamous cell carcinomas are the most severe among them. We report a patient with skin and mouth carcinomas after hydroxyurea treatment. To the best of our knowledge, this is the first case reported.

A 83-year-old woman had been treated with hydroxyurea from 1985 to 1998 for polycythemia vera. She was referred to our institution in 1998 for painful erosions of both hands. Clinical examination revealed a squamous cell carcinoma leading to amputation of a finger. Hydroxyurea was stopped at this time, and the patient underwent treatment with pipobroman. From May 1998 to March 2000, the patient developed numerous skin keratoses and four squamous cell carcinomas on both hands. In September 2000 and October 2000, two additional skin carcinomas and two mouth carcinomas were diagnosed.

Cutaneous carcinomas are severe side effects of hydroxyurea therapy. They usually occur after several years of treatment and their outcome may be lethal. The chronology and clinical signs are in favour of implicating hydroxyurea in the development of skin and mouth carcinomas. Despite a bibliographic research using Medline and Embase data bases, we could not find another case-report with simultaneous occurrence of skin and mouth carcinomas after hydroxyurea therapy. This observation emphasizes the need of a long term follow-up in patients receiving hydroxyurea.