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Hydroxyurea-associated squamous dysplasia.

Carla Sanchez-Palacios¹, Joan Guitart

¹Department of Dermatology, The Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.

Journal of the American Academy of Dermatology

|July 29, 2004

Summary

Long-term hydroxyurea therapy may lead to squamous dysplasia, a precursor to squamous cell carcinomas. This finding adds to the known skin toxicities associated with hydroxyurea treatment.

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Area of Science:

Oncology
Dermatology
Pharmacology

Background:

Hydroxyurea is a medication used to treat myeloproliferative neoplasms and sickle cell disease.
Cutaneous toxicities are known side effects of hydroxyurea therapy.
Previous reports suggest an association between hydroxyurea and various skin cancers.

Observation:

Two cases of squamous dysplasia associated with long-term hydroxyurea therapy are presented.
A literature review identified 17 additional cases linking hydroxyurea to aggressive squamous cell carcinomas, Bowen's disease, and actinic keratoses.
These conditions predominantly affect sun-exposed areas after a latency period.

Findings:

Squamous dysplasia is identified as a potential precursor lesion.
The study emphasizes the role of hydroxyurea in the development of squamous cell carcinomas.
Pathogenetic mechanisms of hydroxyurea-induced carcinogenicity are discussed.

Implications:

Squamous dysplasia should be recognized as a potential cutaneous toxicity of hydroxyurea.
Increased surveillance for skin lesions in patients on long-term hydroxyurea therapy is warranted.
Further research into the carcinogenic mechanisms of hydroxyurea is needed.

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