Successful treatment of hydroxyurea-associated panniculitis and vasculitis with low-dose methotrexate

INTRODUCTION Hydroxyurea is a standard treatment for myeloproliferative disorders because of its cytoreductive effects on all bone marrow cell lines. As a hydroxylated derivative of urea, it inhibits DNA synthesis by inactivating ribonucleotide diphosphate reductase. Hydroxyurea is generally well tolerated. However, a variety of cutaneous side effects including leg ulcers, dermatomyositis, and hyperpigmentations have been described. Here we present a rare case of concomitant medium-vessel vasculitis and panniculitis associated with hydroxyurea therapy successfully treated with low-dose methotrexate.