Fig. 1. Serial clinical images. (A) Skin lesion at initial visit featuring multiple red to violaceous papules and plaques with severe oozing and edema on the feet, leukocyte count (63,500/mm³) (B) Aggravation of skin lesion after dosage reduction of hydroxyurea (hydroxycarbamide 0.5 g) leukocyte count (113,000/mm³) (C) Aggravation of skin lesion despite initial dosage of hydroxyurea (hydroxycarbamide 1 g) leukocyte count (98,150/mm³) (D) Improvement of skin lesion after double of initial hydroxyurea dosage (hydroxycarbamide 2 g) with concomitant improvement of leukocytosis, leukocyte count (22,000/mm³).