Oral Lesions Associated With Hydroxyurea Treatment

Hydroxyurea (HU) is an antimetabolic agent commonly used in myeloproliferative disorders and hematological diseases as well as in severe psoriasis. Despite of usually be well tolerated, sometimes it can induce immunosuppression and mucocutaneous adverse effects associated with discomfort or pain. Nevertheless, oral mucosal adverse reactions are extremely uncommon and present as ulcers, tongue depapilation and dyschromia. Complete remission of adverse effects is usually observed after withdrawal of the medication. The aim of this paper is to report two patients with oral lesions related to HU treatment. T0 he patients were adequately managed by changing hydroxyurea with imatinib mesilate. Oral lesions are rare complications of long-term hydroxyurea treatment and may be an indication of stopping therapy and substitution with imatinib mesilate.226869870De Benedittis, M., Petruzzi, M., Giardina, C., Lo Muzio, L., Favia, G., Serpico, R., Oral squamous cell carcinoma during long-term treatment with hydroxyurea (2004) Clin Exp Dermatol, 29, pp. 605-607Teo, R.Y., Tan, E., A case of hydroxyurea-induced transverse melanonychia (2006) Int J Dermatol, 45, pp. 1329-1330Pamuk, G.E., Turgut, B., Vural, O., Demir, M., Tek, M., Altaner, S., Metastatic squamous cell carcinoma of the skin in chronic myeloid leukaemia: Complication of hydroxyurea therapy (2003) Clin Lab Haem, 25, pp. 329-331Saravu, K., Velappan, P., Lakshmi, N., Shastry, B.A., Thomas, J., Hydroxyurea induced perimalleolar ulcers (2006) J Korean Med Sci, 21, pp. 177-179Norhaya, M.R., Cheong, S.K., Ainoon, O., Hamidah, N.H., Painful oral ulcers with hydroxyurea therapy (1997) Singapore Med J, 38, pp. 283-284Sanches-Palacios, C., Guitart, J., Hydroxyurea-associated squamous dysplasia (2004) J Am Acad Dermatol, 51, pp. 293-300Brincker, H., Christensen, B.E., Acute mucocutaneous toxicity following high-dose hydroxyurea (1993) Can Chem Pharm, 32, pp. 496-49