Hydroxyurea dermopathy: A unique lichenoid eruption complicating long-term therapy with hydroxyurea

Background: Hydroxyurea is usually a well, tolerated antitumor agent. Objective: Our purpose was to describe a distinct clinical and histologic eruption in patients receiving long-term hydroxyurea therapy. Methods: The clinical, histologic, and immunopathologic features of six patients with hydroxyurea dermopathy are described. Results: Three women and three men were identified. The average age was 61 years. Hydroxyurea had been used for an average of 5 years. Lichenoid papules, telangiectasia, and poikilodermatous lesions on the dorsal hands and digits were the most common findings. Interface dermatitis, focal lichenoid reaction with epidermal atrophy, and Civatte bodies were the most common histologic findings. Endothelial swelling also was noted. Cytoid staining with multiple conjugates was the most common immunopathologic finding. Four patients showed significant improvement after discontinuation of hydroxyurea. Conclusion: A distinct cutaneous reaction to long-term administration of hydroxyurea has been characterized. Cessation of treatment is necessary for healing or improvement. We have designated this eruption hydroxurea dermopathy.