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Chronic Penile Ulceration in a 72-Year-Old Man—Diagnosis
Arch Dermatol. 2004;140:877-882.
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Diagnosis: Dermatomyositislike changes on the hands and a lichenoid drug eruption on the penis due to hydroxyurea therapy.
MICROSCOPIC FINDINGS AND CLINICAL COURSE
The biopsy specimen from the glans penis revealed an ulcer with acute and chronic inflammation as well as cytoid bodies at the lateral margin of the ulcer. These findings were suggestive of lichenoid drug eruption, fixed drug eruption, or lichen planus. Following dermatology consultation, the patient's oncologist switched his chemotherapy from hydroxyurea to imatinib mesylate (Gleevec). Follow-up, 3 weeks later, revealed resolution of the penile ulcer along with improvement in the changes on the dorsal aspect of the hands.
DISCUSSION
Hydroxyurea is an antimetabolite that is specific for the S phase of cell division that interferes with DNA synthesis. It is commonly used in the treatment of myeloproliferative disorders. Numerous mucocutaneous changes have been associated with hydroxyurea therapy, including mucocutaneous atrophy with telangiectasia, mucocutaneous or nail hyperpigmentation, stomatitis and glossitis, leg ulcers, and dermatomyositislike changes on the dorsal aspect of the hands along with genital or mucosal ulcers.1-3 The simultaneous development . . . [Full Text of this Article]
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Arch Dermatol. 2004;140(7):877-882.
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