Advanced squamous cell carcinoma of the skin induced by long-term hydroxyurea treatment in a patient with essential thrombocythemia
DOI:
https://doi.org/10.2478/AMB-2024-0019Keywords:
squamous cell carcinoma of the skin, essential thrombocythemia, hydroxyurea, cemiplimabAbstract
Background and Objective: SCCs represents 20-30% of the non-melanocytic skin cancers. It is the second most common skin cancer in the U.S. The main risk factors for SCCs development are: skin phototype I-II, excessive UV-exposure, chronic inflammatory skin diseases, radiation exposure and drug usage. Hydroxyurea is a drug used for the treatment of chronic myeloid leukemia, polycythemia vera and essential thrombocythemia. The therapy is associated with development of actinic keratoses, Bowen’s disease, squamous cell carcinoma and basal cell carcinoma. Patients and methods: We present a 70-year-old female patient suffering from essential thrombocythemia, undergoing treatment with hydroxyurea since 2005, who developed advanced squamous cell carcinoma of the skin of the face and wrists. Results: The patient was diagnosed with advanced moderately differentiated SCCs (Grade 2), stage III (T4 N0 M0). Immunotherapy with cemiplimab 350 mg i.v. every 21 days was initiated. After 6 therapeutic cycles decrease of erythema and desquamation was registered. In 2022 the patient had an ischemic stroke, decompensated heart failure and acute kidney insufficiency. Unfortunately the patient died. Conclusions: Patients undergoing long-term hydroxyurea treatment are prone to develop
multiple squamous cell carcinomas of the skin and are subject to regular dermatological examinations.
References
Corchado-Cobos R, García-Sancha N, González-Sarmiento R et al. Cutaneous Squamous Cell Carcinoma: From Biology
to Therapy. Int J Mol Sci 2020; 21(8):2956.
Dourmishev A, Popova L, Dourmishev L. Basal and squamous cell carcinoma: sex, age and location distribution. Skin Cancer and UV Radiation. Berlin, Heidelberg: Springer Berlin Heidelberg, 1997. 540-546.
Waldman A, Schmults C. Cutaneous Squamous Cell Carcinoma. Hematol Oncol Clin North Am 2019; 33(1):1-12.
Tchernev G, Philipov S, Chokoeva A et al. A Patient with Multiple Keratinocyte Cancers (MKC): Uncommon Presentation in a Bulgarian Patient. Open Access Maced J Med Sci. 2018 Jan 25; 6 (1): 120-122.
Musiałek MW, Rybaczek D. Hydroxyurea-The Good, the Bad and the Ugly. Genes (Basel) 2021; 12(7):1096.
Disdier P, Harle JR, Grob JJ et al. Rapid development of multiple squamous-cell carcinomas during chronic granulocytic leukemia. Dermatologica 199; 183: 47-48.
Cantisani C, Kiss N, Naqeshbandi AF et al. Nonmelanoma skin cancer associated with Hydroxyurea treatment: Overview of the literature and our own experience. Dermatol Ther 2019; 32(5):e13043.
Xu Y, Liu J. Hydroxyurea-induced cutaneous squamous cell carcinoma: A case report. World J Clin Cases 2019; 7: 4091-4097.
Sanchez-Palacios C, Guitart J. Hydroxyurea-associated squamous dysplasia. J Am Acad Dermatol 2004; 51(2):293-300.
Broshtilova V, Gantcheva M. Urticarial Dermatitis–a Define Clinical Entity or a Predilection Histological Marker?. ANTHROPOLOGY AND ANATOMY 28 (2) 28: 38.
Sakano K, Oikawa S, Hasegawa K et al. Hydroxyurea induces site-specific DNA damage via formation of hydrogen peroxide and nitric oxide. Jpn J Cancer Res. 2001 Nov; 92(11):1166-1174.
Kerdoud O, Aloua R, Kaouani A et al. Squamous cell carcinoma during long term hydroxyurea treatment: A case report. Int J Surg Case Rep 2021; 85:106160.
Hoff NP, Akanay-Diesel S, Pippirs U et al. Kutane Nebenwirkungen einer Hydroxyurea-Therapie bei Polycythaemia vera. Hautarzt 60 2009: 783-787
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Copyright (c) 2024 P. Vasilev, M. Karaivanov, D. Dimitrov, `P. Troyanova, I. Yordanova (Author)
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Journal Acta Medica Bulgarica 
