Speaker Credentials
OMS-II
College
Dr. Kiran C. Patel College of Osteopathic Medicine, DO
Medical Specialty
Dermatology
Format
Presentation
Start Date
November 2024
End Date
November 2024
Track
3
Abstract
Introduction. This case report presents a unique instance of a fixed drug eruption (FDE) and melanonychia linked to Hydroxyurea, a chemotherapeutic agent commonly used in the treatment of myeloproliferative disorders. FDEs are localized, cutaneous adverse reactions that recur at the same location upon re-exposure to the offending drug, with potential involvement of additional sites upon subsequent exposures. Deviation From Expected. While known for causing various dermatologic side effects, Hydroxyurea has been rarely associated with FDEs, making this case noteworthy. Case Presentation. A 63-year-old African American female was referred to us by her primary care physician (PCP) for growing dark spots on her nails, hands, and feet. The patient had been previously diagnosed with JAK2 positive primary/essential thrombocytosis by her hematologist who then started her on Hydroxyurea 500mg one month before the spots appeared. Discussion. The correlation between the onset of hyperpigmentation and the spread of the lesions with continuous Hydroxyurea use supported the diagnosis of a Hydroxyurea-induced fixed drug eruption even without a previous episodic reference. Conclusion. Hydroxyurea is a drug with several reported dermatologic adverse effects. FDEs present a wide range of visual, symptomatic, histopathological, and chronological manifestations, making them difficult to diagnose. Because of this, one may need to resort to a diagnosis of exclusion. This is especially true when suspecting drugs that present with uncommonly reported variants of their adverse effects or when dealing with patients who have ingested them for the first time, thus lacking a previous episodic reference point, as seen with in our patient.
Fixed Drug Reaction and Melanonychia from Hydroxyurea
Introduction. This case report presents a unique instance of a fixed drug eruption (FDE) and melanonychia linked to Hydroxyurea, a chemotherapeutic agent commonly used in the treatment of myeloproliferative disorders. FDEs are localized, cutaneous adverse reactions that recur at the same location upon re-exposure to the offending drug, with potential involvement of additional sites upon subsequent exposures. Deviation From Expected. While known for causing various dermatologic side effects, Hydroxyurea has been rarely associated with FDEs, making this case noteworthy. Case Presentation. A 63-year-old African American female was referred to us by her primary care physician (PCP) for growing dark spots on her nails, hands, and feet. The patient had been previously diagnosed with JAK2 positive primary/essential thrombocytosis by her hematologist who then started her on Hydroxyurea 500mg one month before the spots appeared. Discussion. The correlation between the onset of hyperpigmentation and the spread of the lesions with continuous Hydroxyurea use supported the diagnosis of a Hydroxyurea-induced fixed drug eruption even without a previous episodic reference. Conclusion. Hydroxyurea is a drug with several reported dermatologic adverse effects. FDEs present a wide range of visual, symptomatic, histopathological, and chronological manifestations, making them difficult to diagnose. Because of this, one may need to resort to a diagnosis of exclusion. This is especially true when suspecting drugs that present with uncommonly reported variants of their adverse effects or when dealing with patients who have ingested them for the first time, thus lacking a previous episodic reference point, as seen with in our patient.