Chronic leg ulceration associated with polycythemia vera responding to ruxolitinib (Jakafi(®))

J Foot Ankle Surg. 2013 Nov-Dec;52(6):781-5. doi: 10.1053/j.jfas.2013.07.003. Epub 2013 Aug 14.

Abstract

We present the case of a 63-year-old white male with bilateral chronic leg ulcers due to polycythemia vera and hydroxyurea therapy who demonstrated dramatic healing of his wounds in response to ruxolitinib (Jakafi(®), Novartis), a novel Janus kinase-1 and -2 inhibitor. This patient's wound had previously been refractory to multiple surgical interventions and immunosuppression. After the initiation of ruxolitinib, the patient underwent successful split-thickness skin grafting, with resultant healing of his wounds. He was stable without prednisone and other immunosuppressant therapy and had healed at 6 months. Ruxolitinib therapy could represent a novel option for patients who develop persistent inflammatory wounds in the setting of polycythemia vera and hydroxyurea therapy.

Keywords: 4; chronic wound; hydroxyurea; leg ulcer; polycythemia vera; pyoderma gangrenosum; split-thickness skin graft.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Antimetabolites / adverse effects
  • Chronic Disease
  • Enzyme Inhibitors / pharmacology
  • Enzyme Inhibitors / therapeutic use*
  • Humans
  • Hydroxyurea / adverse effects
  • Janus Kinases / antagonists & inhibitors*
  • Leg
  • Male
  • Middle Aged
  • Nitriles
  • Polycythemia Vera / complications*
  • Pyrazoles / pharmacology
  • Pyrazoles / therapeutic use*
  • Pyrimidines
  • Skin Transplantation
  • Skin Ulcer / drug therapy*
  • Skin Ulcer / surgery
  • Wound Healing / drug effects*
  • Wounds and Injuries / drug therapy
  • Wounds and Injuries / surgery

Substances

  • Antimetabolites
  • Enzyme Inhibitors
  • Nitriles
  • Pyrazoles
  • Pyrimidines
  • ruxolitinib
  • Janus Kinases
  • Hydroxyurea