Hypopigmented macules secondary to imatinib for the treatment of chronic myeloid leukemia: a histopathologic and immunohistochemical study

被引:10
作者
Llamas-Velasco, Mar [1 ]
Fraga, Javier [2 ]
Kutzner, Heinz [3 ]
Luis Steegmann, Juan [4 ]
Garcia-Diez, Amaro [1 ]
Requena, Luis [5 ]
机构
[1] Hosp Univ Princesa, Inst Invest Sanitaria La Princesa IP, Dept Dermatol, Madrid 28006, Spain
[2] Hosp Univ Princesa, Inst Invest Sanitaria La Princesa IP, Dept Pathol, Madrid 28006, Spain
[3] Dermatopathol Friedrichshafen, Dept Dermatopathol, Friedrichshafen, Germany
[4] Hosp Univ Princesa, Inst Invest Sanitaria La Princesa IP, Dept Haematol, Madrid 28006, Spain
[5] Fdn Jimenez Diaz, Dept Dermatol, E-28040 Madrid, Spain
关键词
chronic myelogenous leukemia; immunohistochemistry; Melan-A; vitiligo; MESYLATE CAUSES HYPOPIGMENTATION; SUN-EXPOSED SKIN; IN-VITRO; VITILIGO; MELANOCYTES; PIGMENTATION; MELANOMA; THERAPY; STI-571; DISEASE;
D O I
10.1111/cup.12298
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background A few series addressing the cutaneous side effects related to imatinib in the skin have been published, but only one described scarce histopathologic information in seven patients. Objective To characterize these lesions and compare the number of melanocytes between hypopigmented lesions and normal appearing skin. Methods We retrieved clinical data of the patients and performed 24 skin biopsies (13 from hypopigmented skin and 11 from normal-appearing skin) within a cohort of 41 patients with chronic myeloid leukemia treated with imatinib. We classified the biopsies into three patterns. Results About 45% of patients presented with periocular hypopigmentation. Perifollicular fibrosis was observed in hypopigmented skin biopsies (76.9%) and in normal-appearing skin (45.5%). Epidermal melanin, as determined with Masson-Fontana staining, and melanocyte number, as evaluated with MiTF, Melan A and c-kit immunostains, were lower in hypopigmented skin. Conclusions Histopathologic study of hypopigmented macules demonstrates the presence of melanin with a statistically significant decrease in the number of melanocytes. Therefore, these findings differ from vitiligo, as melanocytes are present. Three histopathological patterns may be found, namely (a) perifollicular fibrosis, (b) lichen planopilaris-like and (c) apparently normal skin. One of the most striking histopathologic finding consisted of the presence of perifollicular fibrosis in both hypopigmented lesions and apparently normal skin.
引用
收藏
页码:417 / 426
页数:10
相关论文
共 32 条
[21]  
Llamas-Velasco M, 2013, AM J DERMATOPATHOL
[22]   Quantification of melanocytes in sun-damaged skin [J].
Madden, Katherine ;
Forman, Seth B. ;
Elston, Dirk .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 2011, 64 (03) :548-552
[23]   Reversible hair depigmentation in a patient treated with imatinib [J].
Mariani, Stefania ;
Abruzzese, Elisabetta ;
Basciani, Sabrina ;
Fiore, Daniela ;
Persichetti, Agnese ;
Watanabe, Mikiko ;
Spera, Giovanni ;
Gnessi, Lucio .
LEUKEMIA RESEARCH, 2011, 35 (06) :E64-E66
[24]  
McPartlin S, 2005, Br J Haematol, V129, P448, DOI 10.1111/j.1365-2141.2005.05431.x
[25]   Imatinib-associated hyperpigmentation, a side effect that should be recognized [J].
Mcpherson, T. ;
Sherman, V. ;
Turner, R. .
JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY, 2009, 23 (01) :83-83
[26]   Transient perforating folliculitis induced by sorafenib [J].
Minami-Hori, Masako ;
Ishida-Yamamoto, Akemi ;
Komatsu, Shigetsuna ;
Iiduka, Hajime .
JOURNAL OF DERMATOLOGY, 2010, 37 (09) :833-834
[27]   Challenges in oncology - Case 3. Depigmentation in a chronic myeloid leukemia patient treated with STI-571 [J].
Raanani, P ;
Goldman, JM ;
Ben-Bassat, I .
JOURNAL OF CLINICAL ONCOLOGY, 2002, 20 (03) :869-870
[28]  
Sharma Atul, 2005, Indian J Dermatol Venereol Leprol, V71, P45
[29]   Decreased CD117 expression in hypopigmented mycosis fungoides correlates with hypomelanosis: lessons learned from vitiligo [J].
Singh, Zeba N. ;
Tretiakova, Maria S. ;
Shea, Christopher R. ;
Petronic-Rosic, Vesna M. .
MODERN PATHOLOGY, 2006, 19 (09) :1255-1260
[30]   Imatinib mesylate causes hypopigmentation in the skin [J].
Tsao, AS ;
Kantarjian, H ;
Cortes, J ;
O'Brien, S ;
Talpaz, M .
CANCER, 2003, 98 (11) :2483-2487