Reactions 1475, p22 - 26 Oct 2013

Imatinib

Generalised lichenoid drug eruption: case reportA 63-year-old man developed a generalised lichenoid drug

eruption (LDE) while receiving imatinib for chronic myeloidleukaemia.

The man was referred with a 3-week history of acute onset,itchy, raised, purple and fairly generalised skin lesions over hisbody. Two months before the onset of the lesions, he hadstarted monotherapy with imatinib 400 mg/day [route notstated]. Considering the skin lesions, imatinib had beenwithdrawn 10 days earlier, and he reported a mildimprovement to the lesions. Upon the current presentation,cutaneous examination showed numerous, well-defined,violaceous and coalescing papules and plaques over his limbs,chest, back and abdomen. He had a few scatteredhyperkeratotic papules on his palms. The lesionsdemonstrated koebnerisation on his chest wall. There was alsofine scaling. Biopsies showed an epidermis withhyperkeratosis, as well as focal parakeratosis, focal wedge-shaped hypergranulosis and irregular acanthosis. Based onclinical and histopathological examination, he was diagnosedwith generalised LDE associated with imatinib.

The man received clobetasol and antihistamines. Within acouple of weeks, almost all lesions resolved with residual post-inflammatory hyperpigmentation, and new lesions stoppedappearing.

Imatinib was gradually re-introduced to reach 400 mg/day.Subsequently, only a few new lesions re-appeared. The manwas maintained on steroids with excellent control of the skincondition.

Author comment: "A case of a generalized lichenoid drugeruption (LDE) associated with imatinib mesylate therapy hasbeen described here for its rarity and unusual clinicalpresentation. . . according to the Naranjo probability scale foradverse drug reaction, this diagnosis was "highly probable"."Ghosh SK. Generalized lichenoid drug eruption associated with imatinib mesylatetherapy. Indian Journal of Dermatology 58: 388-392, No. 5, Sep-Oct 2013.Available from: URL: http://dx.doi.org/10.4103/0019-5154.117315 -India 803094814

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Reactions 26 Oct 2013 No. 14750114-9954/13/1475-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved