羟基脲是一种化疗药物,用于骨髓增殖性疾病和镰状细胞性贫血,众所周知会引起皮肤粘膜溃疡。通常涉及腿或嘴。然而,由于羟基脲治疗引起的生殖器溃疡是罕见的,可能被低估了,不良反应,迄今文献报道的只有少数病例。由羟基脲引起的小腿溃疡与诊断延迟有关,由于缺乏意识,在生殖器溃疡的情况下,这可能会加剧。在此,我们介绍了2例接受羟基脲治疗的患者的生殖器溃疡疼痛。在第一个案例中,一名87岁男性真性红细胞增多症在阴囊上出现溃疡,最初是通过COVID-19大流行期间的虚拟访问进行评估的,局部和口服抗生素治疗难以治疗。第二例是一名79岁的男性,患有原发性血小板增多症,并有持续性腿部溃疡的病史,并发展了龟头糜烂。两名患者在停止羟基脲治疗后的几周内都经历了完全缓解。总之,由羟基脲引起的生殖器溃疡和糜烂在临床实践中可能被低估,但如果被确认,退出羟基脲导致这些病变和相关疼痛的快速解决。
Hydroxyurea is a chemotherapeutic agent used for myeloproliferative disorders and sickle cell anemia that is well known to cause painful mucocutaneous ulcers, typically involving the legs or mouth. However, genital ulcerations due to hydroxyurea therapy are a rare, and likely underrecognized, adverse effect with only a few cases reported in the literature to date. Ulcers of the lower legs caused by hydroxyurea are associated with a diagnostic delay, and this is likely exacerbated in cases of genital ulceration due to a lack of awareness. Herein we present two cases of painful genital ulceration in patients on hydroxyurea therapy. In the first
Case, an 87 year-old male with polycythemia vera developed an ulcer on the scrotum, which was assessed initially through virtual visits during the COVID-19 pandemic, and was refractory to topical and oral antibiotic treatments. The second
case was a 79 year-old male with essential thrombocythemia and a history of persistent leg ulcers who developed erosions of the glans penis. Both patients experienced complete resolution within weeks of discontinuing hydroxyurea therapy. In conclusion, genital ulcers and erosions induced by hydroxyrea may be underrecognized in clinical practice, but if identified, withdrawal of hydroxyurea leads to quick resolution of these lesions and the associated pain.