Imatinib mesylate induced acquired dermal melanocytosis: A Rare Case Report
Keywords:
acquired dermal melanocytosis, imatinib mesylate, Q-switched Nd:YAG 1064 nmAbstract
Imatinib mesylate induced acquired dermal melanocytosis is a very rare condition. Many reports have linked secondary pigmentary changes to treatment with imatinib mesylate. These changes are generally characterized by hypopigmentation and depigmentation but rarely hyperpigmentation. Among hyperpigmentation case reports, only one case of imatinib mesylate induced acquired dermal melanocytosis has been reported until now. We report case of a patient who presented with bilateral blue-greyish macules and patches on the temporal, periocular areas, upper conjunctivae and the hard palate. The patient has been diagnosed with chronic myeloid leukemia and concurrently treated with imatinib mesylate 300 mg/day. The skin biopsy was performed to confirm the diagnosis. Histopathology of the skin lesion showed few dermal melanin-containing dendritic cells in the upper dermis. Immunohistochemistry revealed positive dermal dendritic cells with S100 and Melan-A. Accordingly, the patient was diagnosed with acquired dermal melanocytosis, mostly from imatinib mesylate induced. The patient was treated with Q-switched Nd:YAG 1064 nm and 3% hydroquinone cream. Consequently, there has been a slight improvement of the patient’s lesions. However, the patient could not discontinue taking imatinib mesylate due to the treatment for leukemia.
References
2. Amitay-Laish I, Stemmer SM, Lacouture ME. Adverse cutaneous reactions secondary to tyrosine kinase inhibitors including imatinib mesylate, nilotinib, and dasatinib. Dermatol Ther 2011; 24:386-95.
3. Alexandrescu DT, Dasanu CA, Farzanmehr H, Kauffman L. Persistent cutaneous hyperpigmentation after tyrosine kinase inhibition with imatinib for GIST. Dermatol Online J 2008; 14: 7.
4. Hwang JE, Yoon JY, Bae WK, Shim HJ, Cho SH, Chung IJ. Imatinib induced severe skin reactions and neutropenia in a patient with gastrointestinal stromal tumor. BMC Cancer 2010; 10: 438.
5. Arora B, Kumar L, Sharma A, Wadhwa J, Kochupillai V. Pigmentary changes in chronic myeloid leukemia patients treated with imatinib mesylate. Ann Oncol 2004; 15: 358-9.
6. Mohan RP, Verma S, Singh AK, Singh U. 'Nevi of Ota: the unusual birthmarks': a case review. BMJ Case Rep 2013; 2013.
7. Jovovic-Dagovic B, Ravic-Nikolic A, Milicic V, Ristic G. Bilateral nevus of Ota in a light-skinned woman. Dermatol Online J 2007; 13: 19.
8. Turnbull JR, Assaf C, Zouboulis C, Tebbe B. Bilateral naevus of Ota: a rare manifestation in a Caucasian. J Eur Acad Dermatol Venereol 2004; 18: 353-5.
9. Chang SE, Kim KJ, Kim ES, et al. Two cases of late onset Ota's naevus. Clin Exp Dermatol 2002; 27: 202- 4.
10. Wang BQ, Shen ZY, Fei Y, et al. A population-based study of acquired bilateral nevus-of-Ota-like macules in Shanghai, China. J Invest Dermatol 2011; 131: 358- 62.
11. Zhang Q, Jiang P, Tan C, Yang G. Clinical profile and triggering factors for acquired, bilateral nevus of Otalike macules. Cutan Ocul Toxicol 2017; 36327-330.
12. Eun Kyung Kim, Kyung Eun Jung, Hei Sung Kim, Young Min Park, Hyung Ok Kim, Jun Young Lee. Imatinib Mesylate Induced Acquired Dermal Melanocytosis. Korean J Dermatol. 2012; 50:747-50.
13. Jha P, Himanshu D, Jain N, Singh AK. Imatinib-induced Stevens-Johnsons syndrome. BMJ Case Rep 2013; 2013.
14. Lewis DM. Diffuse pigmentation of the palate. J Okla Dent Assoc 2009; 100: 24-5.
15. Legros L, Cassuto JP, Ortonne JP. Imatinib mesilate (Glivec): a systemic depigmenting agent for extensive vitiligo? Br J Dermatol 2005; 153: 691-2.
16. Song HS, Kang HY. Imatinib mesylate-induced hyperpigmentation of the nose and palate. Ann Dermatol 2014; 26: 532-3.
17. Mcpherson T, Sherman V, Turner R. Imatinibassociated hyperpigmentation, a side effect that should be recognized. J Eur Acad Dermatol Venereol 2009; 23: 82-3.
18. Balagula Y, Pulitzer MP, Maki RG, Myskowski PL. Pigmentary changes in a patient treated with imatinib. J Druqs Dermatol 2011; 10: 1062-6.
19. Resende RG, Teixeira RG, Vasconcelos Fde O, Silva ME, Abreu MH, Gomez RS. Imatinib-associated hyperpigmentation of the palate in post-HSCT patient. J Craniomzxillofac Surg 2012; 40: e140-3.
20. Singh N, Bakhshi S. Imatinib-induced dental hyperpigmentation in childhood chronic myeloid leukemia. J Pediatr Hematol Oncol 2007; 29: 208-9.
21. Ghunawat S, Sarkar R, Garg VK. Imatinib induced melasma-like pigmentation: Report of five cases and review of literature. Indian J Dermatol Venereol Leprol 2016; 82: 409-12.
22. Li CC, Malik SM, Blaeser BF, et al. Mucosal pigmentation caused by imatinib: report of three cases. Head Neck Pathol 2012; 6: 290-5.
23. Wong M, Sade S, Gilbert M, Klieb HB. Oral melanosis after tyrosine kinase inhibition with Imatinib for chronic myelogenous leukemia: report of a case and review of the literature. Dermatol Online J 2011; 17: 4.
Downloads
Published
How to Cite
Issue
Section
License
เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใดๆ
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นลิขสิทธิ์ของวารสารฯ หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใดๆ จะต้องได้รับอนุญาตเป็นลายลักอักษรจากบรรณาธิการวารสารโรคผิวหนังก่อนเท่านั้น
