[An 84-year-old man with an ulcer on his ankle]

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Hydroxycarbamide is a cytotoxic drug utilized in managing hematological malignancies.
• Long-term administration (2-15 years) at doses of 1500-2000 mg daily is associated with a 9% risk of ulcer development.

Observation:

• A patient presented with a painful ulcer characterized by a punched-out appearance, necrotic base, and edematous wound margins.
• The ulcer developed during prolonged hydroxycarbamide therapy.

Findings:

• Discontinuation of hydroxycarbamide treatment resulted in complete ulcer healing.
• The patient's ulcer resolved within a two-month period after drug cessation.

Implications:

• This case highlights a potential adverse effect of hydroxycarbamide, specifically cutaneous ulceration.
• Physicians should consider hydroxycarbamide-induced ulcers in patients with hematological cancers presenting with similar lesions.
• Drug cessation may be an effective management strategy for these ulcers.