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Figure 1:
Lesions before discontinuation of hydroxyurea. (a and b) Numerous ulcers with well-defined borders located on the dorsum of the fingers can be seen. Also, appreciate the reddish hue on the back of the interphalangeal and metacarpophalangeal joints, creating a “pseudo-Gottron” pattern, like dermatomyositis. Nail brittleness and melanonychia are seen, features that are also widely described in urea toxicity. In (c), a dermatoscopic detail of the lesions can be seen, showing ulcers with very well-defined borders, with a whitish halo surrounded by another more erythematous one on the outside. The appearance of the ulcer is crusty and dry. (d) Shows detail of involvement in the palmar aspect.
Figure 2:
Lesions after discontinuation of hydroxyurea. One month after discontinuation of therapy, the patient showed a notable improvement in the lesions (a), in the case of smaller and clinically asymptomatic ulcers. In (b), improvement is also seen at the palmar level.