Anamnesis and clinical findings: Extremely painful leg ulcers on the lateral aspect of both ankles developed in a 38-year-old man for the first time six weeks after starting treatment with anagrelide for thrombocythemia.
Investigations: Extensive diagnostic tests, including laboratory tests, Doppler and duplex ultrasound of the superficial and deep leg veins, histopathology and bacteriological and mycological tests excluded vascular disease, vasculitis and metabolic causes.
Therapy and course: Despite adequate local treatment the ulcerations did not improve until anagrelide was discontinued and replaced by hydroxyurea.
Conclusion: Anagrelide administration was the most likely cause of the leg ulcerations, even though this possible side effect has only been described once in the literature.