Atypical Wounds in Chronic Graft‐Versus‐Host Disease and Peripheral Arterial Disease Caused by Tyrosine Kinase Inhibitors

ABSTRACT The term “atypical wounds” primarily refers to lesions with immunological or cancerous etiologies. However, these wounds can also be drug‐induced. We report about a 32‐year‐old man with a 6‐year history of chronic myelogenous leukemia (CML) and chronic graft‐versus‐host disease (cGvHD) following an HLA‐compatible allogeneic stem cell transplantation with multiple ulcers on both lower extremities, some of which extended deep to the muscle fascia. Late diagnosis and treatment of peripheral arterial disease (PAD) and unsuccessful revascularization led to an above‐knee amputation on the right side. Despite the patient's persistent poor circulation, the wounds on both sides healed and he regained his independence. This complex case illustrates a partial therapeutic success in the treatment of multifactorial atypical wounds, stemming from a combination of cGvHD and micro‐ and macroangiopathy most likely induced by antineoplastic therapy. image