From the Guidelines
Yes, hydroxyurea can cause cutaneous hypersensitivity and pain. It is recommended to exercise caution when taking hydroxyurea, as it may lead to cutaneous side effects, including skin ulcers, dermatomyositis, and painful skin lesions 1. Patients taking hydroxyurea, particularly at high doses (above 1000 mg/day) or for extended durations (longer than 6 months), should be closely monitored for signs of skin sensitivity and pain.
Key Considerations
- Dermatologic reactions are a known toxicity of hydroxyurea, including rash, ulceration, dermatomyositis-like skin changes, and alopecia 1.
- Mucocutaneous manifestations are also a potential side effect, including oral and skin ulcers, and hyperpigmentation 1.
- Leg ulcers are a specific type of cutaneous side effect that can occur with hydroxyurea use 1. If symptoms occur, it is advised to consult a healthcare provider for proper evaluation and management. Regular monitoring, including baseline and ongoing monitoring of complete blood cell counts and physical examinations, can help identify potential side effects early on 1.
From the FDA Drug Label
In patients who have demonstrated a previous hypersensitivity to hydroxyurea or any other component of its formulation. (4) Acute mucocutaneous toxicity has been reported in patients receiving hydroxyurea at dosages several times the therapeutic dose. Soreness, violet erythema, edema on palms and soles followed by scaling of hands and feet, severe generalized hyperpigmentation of the skin, and stomatitis have also been observed.
Yes, hydroxyurea can cause cutaneous hypersensitivity and pain, as evidenced by reports of soreness, violet erythema, edema, and scaling of hands and feet in patients receiving the drug, particularly at high dosages 2 2. Key symptoms include:
- Soreness
- Violet erythema
- Edema on palms and soles
- Scaling of hands and feet
- Severe generalized hyperpigmentation of the skin
From the Research
Cutaneous Side Effects of Hydroxyurea
- Hydroxyurea is known to cause a broad spectrum of cutaneous side effects, ranging from relatively benign to severe 3
- Common cutaneous side effects include hyperpigmentation, xerosis, and skin atrophy 3
- Serious cutaneous side effects such as leg ulcers, nonmelanoma skin cancers, and leucocytoclastic vasculitis can occur in patients taking hydroxyurea 3, 4, 5, 6, 7
Painful Cutaneous Side Effects
- Painful leg ulcers have been reported in patients taking hydroxyurea 5, 7
- Oral ulcers have also been reported as a cutaneous side effect of hydroxyurea 6
- Acral keratoses and psoriasiform plaques can occur in patients taking hydroxyurea, which can be painful and resistant to treatment 4
Management of Cutaneous Side Effects
- Discontinuation of hydroxyurea therapy can lead to rapid improvement of cutaneous side effects 4, 5
- A conservative and systematic wound-healing strategy can be effective in treating leg ulcers without discontinuing hydroxyurea therapy 7
- Close monitoring by dermatologists is crucial for early detection and treatment of cutaneous side effects 3, 5