Imatinib-Induced Lichen Planus in Chronic Myeloid Leukemia: A Case Series

Abstract

Chronic myeloid leukemia (CML) is a myeloproliferative disorder in which the Philadelphia chromosome is the cytogenetic hallmark. It is characterized by the t (9;22) translocation, which in turn creates the chimeric BCR-ABL oncogene coding for a constitutively activated tyrosine kinase. Imatinib mesylate is a tyrosine kinase inhibitor that targets the BCR-ABL protein, c-KIT, and platelet-derived growth factor (PDGF) receptors and is used to treat CML, gastrointestinal stromal tumors, and dermato-fibrosarcoma protuberant. The development of the specific inhibitor of BCR-ABL tyrosine kinase has been a notable success and approved as the first-line treatment for CML. Although adverse cutaneous reactions to imatinib mesylate are not infrequent, their clinical and histopathological features have generally been poorly characterized. Here we report three rare cases of cutaneous lichenoid eruptions that occurred during the treatment of CML with imatinib mesylate.

Keywords: chronic myeloid leukaemia; drug reaction; imatinib mesylate; leukemoid reaction; lichen planus.

Figure 1. Multiple violaceous flat-topped papules over the trunk

Figure 2. Multiple hyperpigmented, scaly patches and a few plaques noted over both hands and forearms

Figure 3. Numerous violaceous raised papules noted over both legs