Vasculitic leg ulcers in chronic myelogenous leukemia

Recurrent bilateral leg ulcers developed in two patients receiving hydroxyurea therapy during the chronic phase of chronic myelogenous leukemia. The ulcers were extremely painful and were associated with extensive edema and vasculitic papules. A small-vessel vasculitis with degeneration of collagen and ulceration was seen on biopsy. The ulcers did not respond to treatment with steroids or low-dose cyclophosphamide but gradually healed with local measures. The possible pathogenesis of ulcers in chronic myelogenous leukemia is discussed.