Multiple Skin Cancers Associated With Hydroxyurea: Case Report and Review of Literature

Hydroxyurea (HU) is an antimetabolite used to treat different myeloproliferative disorders, including chronic myeloid leukemia, polycythemia vera, and essential thrombocytopenia (ET). HU has a significant effect on the treatment of myeloproliferative disease.

A 54-year-old woman with a history of ET from 15 years ago presented with multiple erythematous plaques and ulcers on the face and extremities from 2 years ago. She had multiple SCCs, Bowen, and AK on both extremities and face. We reviewed and summarized the literature on the relationship between HU and nonmelanoma skin cancer (NMSC) between 1991 and 2022. Sixty cases (37 men and 23 women) were evaluated. The participants' mean age was 66.73 ± 9.80 years. They received the HU therapy for 9.17 ± 4.29 years. The latency period to the occurrence of symptoms in patients with HU-related skin cancer was 7.33 ± 4.40 years. The HU dose in these patients ranged from 1.21 ± 0.53 g/d. Among NMSCs, SCCs are more frequently associated with the HU treatment, followed by AKs, BCCs, and Bowen.

Healthcare providers should be aware of skin cancer risks; patients receiving long-term HU therapy should be screened for early diagnosis and provided with preventive measures and appropriate treatment.