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Hydroxyurea-Induced Leg Ulcers Treated With a Protease-Modulating Matrix
Marco Romanelli, MD, PhD;
Valentina Dini, MD;
Paolo Romanelli, MD
Arch Dermatol. 2007;143(10):1310-1313.
Background The development of painful leg ulcers in the ankle area is a rare and only partially described complication in patients receiving high-dose, long-term hydroxyurea treatment for myeloproliferative diseases. Several reports have described treatments for chronic wound management with this type of lesion.
Observations We describe 2 patients who were diagnosed as having hydroxyurea-induced leg ulcers that were successfully treated with a freeze-dried sponge containing oxidized regenerated cellulose and bovine purified collagen. This dressing is able to modulate the activity of proteases such as plasmin, neutrophil-derived elastase, and matrix metalloproteinase by physically entrapping them and thus inhibiting their activity.
Conclusion This case demonstrates that topical application of a matrix metalloproteinase modulator can be a successful and safe treatment option for patients with hydroxyurea-induced recalcitrant leg ulcers.
Author Affiliations: Department of Dermatology, University of Pisa, Pisa, Italy (Drs M. Romanelli and Dini); and Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida (Dr P. Romanelli).
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