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Chemotherapy-induced Vascular Toxicity - Real-time In vivo Imaging of Vessel Impairment
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Chemotherapy-induced leg ulcers: a case series.
Marion Rousselot1, Emmanuel Mahé1, Patricia Senet2
1MD, Service de Dermatologie et Médecine Vasculaire, Centre Hospitalier Victor Dupouy, Argenteuil, France.
Journal of Wound Care
|March 6, 2025
Summary
Chemotherapy, including tyrosine kinase inhibitors (TKIs) and taxanes, can cause leg ulcers (LUs). These ulcers appear faster with TKIs and taxanes than hydroxyurea, but heal quickly after stopping treatment.
Area of Science:
- Oncology
- Dermatology
- Pharmacology
Background:
- New chemotherapy agents, such as tyrosine kinase inhibitors (TKIs), are associated with cutaneous side effects.
- Leg ulcers (LUs) are an emerging concern with certain chemotherapy treatments.
Purpose of the Study:
- To analyze the development, characteristics, and management of leg ulcers (LUs) in patients undergoing chemotherapy.
- To identify differences in LU onset and presentation across various chemotherapy classes.
Main Methods:
- A retrospective multicenter study involving 45 patients across nine French dermatology and one hematology department.
- Data collected included cancer history, LU cofactors, management, and evolution.
- Patients were categorized into three groups: hydroxyurea, targeted therapies (including TKIs), and taxane treatment.
Main Results:
- Leg ulcers (LUs) appeared significantly faster in patients treated with taxanes and TKIs compared to hydroxyurea (p<0.0001 and p=0.004, respectively).
- Common factors for LUs included advanced age, vascular cofactors, and pain.
- Chemotherapy was discontinued in 88% of cases, with 91% achieving ulcer healing within an average of 4.6 months.
Conclusions:
- Hydroxyurea, targeted therapies (TKIs), and taxanes are implicated in the development of leg ulcers (LUs).
- Prescribers need awareness of these chemotherapy-induced skin toxicities.
- Monitoring for LU cofactors is crucial, especially in patients with pre-existing LU risk factors, and the risk-benefit of discontinuing chemotherapy should be considered.
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