Huge post-operative ulcer following hydroxyurea therapy in a patient with polycythemia vera

A 75-year old woman was referred to our hospital due to a worsening post-operative cutaneous ulcer. She had a history of polycythemia vera and had been treated with a daily dose of 500mg hydroxyurea (HU) for six years. She underwent a right hernioplasty in another hospital in September 2002. Two days after the hernioplasty, the skin around the wound became erythematous and necrosis was observed. Even with the administration of antibiotics and debridment was performed three times, her condition deteriorated and she was referred to our hospital. On admission, a 22x15cm ulcer was observed on the lower abdomen. With termination of HU, the cutaneous ulcer became smaller and with the withdrawal of other medication, the ulcer size continued to decrease. Although post-operative cutaneous ulcer complicated by HU administration has rarely been reported, our case clearly indicates that early termination of HU should be considered when patients develop symptoms preceding cutaneous ulcer.