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Hydroxyurea-Induced Leg Ulceration in a Patient With a Homozygous MTHFR Polymorphism Misdiagnosed as Pyoderma Gangrenosum

Sunita C. Crittenden, MD1; Juliana E. Gilbert, MD1; Jeffrey P. Callen, MD1
[+] Author Affiliations
1Division of Dermatology, University of Louisville, Louisville, Kentucky
JAMA Dermatol. 2014;150(7):780-781. doi:10.1001/jamadermatol.2013.7198.
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Both hydroxyurea, an antimetabolite used to treat chronic myeloproliferative diseases, and methylene tetrahydrofolate reductase (MTHFR) polymorphisms have been associated with cutaneous ulceration.1,2 We present a case of a severe leg ulcer that likely occurred from hydroxyurea use in a patient with a MTHFR polymorphism.

Article InformationCorresponding Author: Sunita C. Crittenden, MD, Division of Dermatology, University of Louisville, Louisville, Kentucky, 310 E Broadway, Floor 2A, Louisville, KY 40202 (sunitacrittenden@gmail.com).

Published Online: March 5, 2014. doi:10.1001/jamadermatol.2013.7198.

Conflict of Interest Disclosures: None reported.

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Clinical Images From the Present Case

A, Large ulceration on the right distal leg with exposed muscle and tendons. B, The ulcer completely healed after discontinuation of hydroxyurea and full-thickness skin graft closure.

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