Sustained Regression of Hydroxycarbamide Induced Actinic Keratoses after Switching to Anagrelide

Figure 1

Complete and sustained remission of extensive hydroxycarbamide-associated skin carcinogenesis fields after switching to anagrelide: exemplary presentation of the alterations on the balding scalp skin. (a) At presentation numerous, confluent, hypertrophic actinic keratoses cover almost the entire scalp. Removal of the hyperkeratosis revealed an oozing erosion (arrow). (b) A significant load of actinic keratoses persists 3 months after onset of treatment with cryosurgery plus ingenol mebutate (7 treatment cycles) and daily 0.32 mg/kg b.w. acitretin. At that point acitretin dose was doubled (0.64 mg/kg b.w./d) and the patient was switched from hydroxycarbamide to anagrelide. (c) Impressive improvement after one month in the last treatment scheme (anagrelide and acitretin, no topical treatments). (d) Sustainable “clearance” of the field 20 months after discontinuation of acitretin and still on anagrelide: complete regression of existing and no development of new actinic keratoses.

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