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Hydroxyurea is an antineoplastic agent used to treat chronic myeloid leukaemia (especially in accelerated phase and blast crisis). We report this unique case of a 60 year old lady who was diagnosed case of chronic-phase of chronic myeloid leukaemia was getting imatinib and well suited. As a consequence of imatinib noncompliance, she developed blast crisis and was subsequently hydroxyurea initiated. At her 3rd month follow-up she presented with blackening of her exposed parts of the body, all three mucocutaneous areas especially skin of her hands, feet, fingernails, toenails and oral mucosa in some extent. Hydroxyurea-induced melanonychia and mucocutaneous hyperpigmentation is rarely reported. To the best of our knowledge, this is one of the few published reports of hydroxyurea induced mucocutaneous hyperpigmentation and melanonychia involving all 20 nails. The mainstays of treatment are withdrawal of the drug and sun-avoidance; laser therapy is a hope for cure in small percentage of permanent cases. A correct diagnosis is essential to prevent undue fears in the patient. Proper advice to the patient regarding adverse reactions of particular agent and close monitoring after prescribing should be ensured to prevent harm to patients. Always should remember, drugs not only save life, but can even take it.

bangladesh critical care journal

Acquired Melanonychia and Mucocutaneous Hyper pigmentation with Hydroxyurea Therapy for the Treatment of Blast Crisis of Chronic Myeloid Leukaemia: A Case Report