[Show abstract][Hide abstract] ABSTRACT: Imatinib mesylate is a drug that has been recently approved for the treatment for chronic myeloid leukemia. It acts as a potent and selective inhibitor of BCR-ABL tyrosine kinase. It also inhibits both c-kit and platelet-derived growth factor receptor tyrosine kinases. Hypopigmentation of the skin in patients receiving this drug has been recently reported. We report a 17-year-old Caucasian patient affected by chronic myeloid leukemia in therapy with imatinib mesylate who developed hypopigmented vitiligo-like patches and generalized lightening of the skin. In order to evaluate the lightening observed clinically, we measured the progressive skin color hypopigmentation by using a colorimeter over several months. The colorimetric evaluation confirmed the generalized and gradual lightening of patient's skin over treatment with imatinib mesylate. We believe that this is the first reported instance of vitiligo-like lesions in a pediatric patient treated with imatinib mesylate, and the second in a Caucasian patient.
No preview · Article · Mar 2006 · Pediatric Dermatology
[Show abstract][Hide abstract] ABSTRACT: Imatinib mesylate (IM) represents the first-line treatment for chronic myeloid leukemia (CML). We hereby relate 3 cases of an IM-induced pityriasis rosea (PR)-like cutaneous eruption. Patients developed an erythematous, slightly pruritic, macular skin eruption, with many lesions having a peripheral collarette of desquamation, confined to the trunk, limbs, and arms with a vaguely dermatomal diffusion. The histologic findings suggested a reactive process to the drug. Full dermatological recovery was obtained after IM discontinuation, but lesions reappeared upon restoring therapy, suggesting the drug-related nature of the rash. To our knowledge this is the first reported PR-like cutaneous eruption to IM.
No preview · Article · Dec 2005 · Journal of the American Academy of Dermatology
[Show abstract][Hide abstract] ABSTRACT: Hydroxyurea (HU) is a cytostatic agent which is widely used in the treatment of myeloproliferative disorders, in particular chronic myeloid leukemia. HU inhibits DNA synthesis through its action on ribonucleoside diphosphate-reductase, which catalyses the reduction of ribonucleotides. Its antitumor effect mainly consists of a decrease in white blood cell count, an increase in hemoglobin to normal values, a decrease of thrombocytosis and a reduction of splenomegaly. Long-term HU therapy causes hematologic side effects, including marrow suppression and megaloblastosis. Cutaneous adverse reactions are frequently described, and consist mainly of atrophy of the skin, leg ulcers, erythema of the face and hands, alopecia, hyperpigmentation of the skin and nail abnormalities. A 77-year-old woman with chronic myeloid leukemia was treated with oral HU (2 g/day) for 15 months. She complained of an ulcer of the left malleolar area, but the physical examination was also remarkable for diffuse and longitudinal nail hyperpigmentation of all the nails of both hands and feet. A diagnosis of HU-induced ulcer and melanonychia was made and HU was discontinued. The patient started a therapy with oral imatinib mesylate (400 mg/day) and oral pentoxifylline (400 mg/day). Two months later, the leg ulcer resolved and the hyperpigmented bands on the fingernails were lighter.
[Show abstract][Hide abstract] ABSTRACT: Thyroid diseases may be associated with a wide variety of dermatologic disorders. We report a 15-year-old girl with acquired ichthyosis and hypertrichosis associated with hypothyroidism resulting from autoimmune thyroiditis. Her skin lesions progressively resolved after 8 months of replacement therapy with L-thyroxine. This result supports the hypothesis that hypothyroidism in our patient can be directly related to the pathogenesis of acquired ichthyosis and hypertrichosis.
No preview · Article · Sep 2005 · Pediatric Dermatology
[Show abstract][Hide abstract] ABSTRACT: We report our experience with UV-B narrowband (UV-B-NB) therapy in children affected by vitiligo. We studied 10 Caucasian Italian children (six boys, four girls, mean age 9.7 years +/- 2.67). Treatment mean term was 5.6 months; frequency was three times a week on nonconsecutive days or only twice a week, because of school or family duties. The percentage of repigmentation was evaluated by comparing photographs taken before, during, and after the treatment, and showed a repigmentation level higher than 75% in five patients (5/10, 50%) and between 26% and 75% in three patients (3/10, 30%). Of our patients, 80% had a satisfactory response to phototherapy. Adverse events were limited and transient. No significant relationships between repigmentation grades and variables such as skin type, positive family history, and disease extension were observed. Some areas responded better than others; the best results were shown on the face and neck. Perhaps we studied too few patients to be conclusive, but the results obtained so far seem to indicate that children affected by recent vitiligo have a better response to the therapy. We feel that UV-B-NB therapy is a valuable and safe option for the treatment of pediatric vitiligo, and should be started as soon as possible.
No preview · Article · May 2005 · Pediatric Dermatology
[Show abstract][Hide abstract] ABSTRACT: Aim. The treatment of vitiligo remains a challenge. In literature various treatment modalities have been proposed. In the present study a long-term narrowband UVB (UVB-NB) approach to vitiligo is proposed in 25 patients. Methods. Treatment frequency was twice a week, on 2 non-consecutive days; treatment was continued for 1 year or discontinued earlier, in case of satisfactory or even complete repigmentation. Photographs of the body surface interested by vitiligo were taken before, during and after treatment; phototherapy responses were expressed as more than 75% repigmentation (group A); between 26% and 75% repigmentation (group B); less than 25% repigmentation (group C) and not responders (group D). Results. At the end of the study (12 months), 11 patients (44%) showed an excellent repigmentation (group A); 8 patients (32%) had a satisfactory good repigmentation (group B); 2 patients (8%) had an unsatisfactory response (group C), and 4 patients (16%) were not responders (group D). The best response was achieved by those patients who had recent vitiligo (100% of patients in group A and 70% of patients in group B). Conclusion. This study suggests that UVB-NB therapy represents a valuable and safe option for vitiligo and confirms that good results are correlated with a long period of continuous therapy; moreover, further improvement could be observed when UVB-NB therapy was prolonged till the end of the first year of treatment or more.
[Show abstract][Hide abstract] ABSTRACT: Hypertrichosis is a disorder characterized by increased terminal hair growth located in non-androgen-dependent areas. It may be congenital or acquired, localized or generalized. Iatrogenic hypertrichosis is a dermatological adverse effect related with various systemic and topical treatments. However, acquired iatrogenic localized hypertrichosis is unusual. The case of a 6-years-old child with a history of atopic dermatitis since she was 1 year old is described. She was treated with topical steroids and emollients. In the last year the child developed well defined areas of excessive terminal hair growth on the trunk. The hair grew over lichenified, erythematous and excoriated areas. Her mother referred that these areas were pruriginous and were treated with topical gentamicin-sulphate and betametasone-17-valerate. The correspondance between excoriated, steroid-treated areas and hypertrichosis led to the diagnosis of acquired localized iatrogenic hypertricosis in an atopic patient.