Hyperpigmentation of the hard palate mucosa in a patient with chronic myeloid leukaemia taking imatinib
Abstract Background Imatinib mesylate is an inhibitor of the tyrosine kinase Bcr–Abl and a first-line treatment for Philadelphia chromosome-positive chronic myeloid leukaemia (CML). Dermatological side effects include superficial oedema, pustular eruption, lichenoid reactions, erythroderma, and skin...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2017-12-01
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| Series: | Maxillofacial Plastic and Reconstructive Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40902-017-0136-y |
| _version_ | 1818586019799236608 |
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| author | Gian Paolo Bombeccari Umberto Garagiola Francesco Pallotti Margherita Rossi Massimo Porrini Aldo Bruno Giannì Francesco Spadari |
| author_facet | Gian Paolo Bombeccari Umberto Garagiola Francesco Pallotti Margherita Rossi Massimo Porrini Aldo Bruno Giannì Francesco Spadari |
| author_sort | Gian Paolo Bombeccari |
| collection | DOAJ |
| description | Abstract Background Imatinib mesylate is an inhibitor of the tyrosine kinase Bcr–Abl and a first-line treatment for Philadelphia chromosome-positive chronic myeloid leukaemia (CML). Dermatological side effects include superficial oedema, pustular eruption, lichenoid reactions, erythroderma, and skin rash. Depigmentation of the skin and/or mucosa is uncommon, and hyperpigmentation is rare. Case presentation We present the case of a 63-year-old Caucasian male with widespread hyperpigmentation of the hard palate associated with a 9-year history of imatinib therapy to treat CML. He did not complain of any symptoms. Clinical examination did not reveal any abnormal pigmentation of the skin or other region of the oral mucosa. He did not smoke cigarettes or drink alcohol. His medication regimen was a proton pump inhibitor, a beta-blocker, cardioaspirin, atorvastatin, and imatinib 400 mg/day. Histopathologically, melanin and haemosiderin deposits were evident in the lamina propria. The lesion persisted, with no clinical change, through several follow-ups. We reviewed the literature to explore the possible relationship between oral hyperpigmentation and long-term imatinib mesylate treatment. Conclusions We diagnosed oral pigmentation associated with imatinib intake based on the medical history and clinical features of the pigmented macules. Oral pigmentation may have a variety of causes, and differential diagnosis requires nodal analysis. Clinicians should be aware of possible oral mucosal hyperpigmentation in patients taking imatinib mesylate. Such pigmentation is benign and no treatment is needed, but surveillance is advisable. |
| first_indexed | 2024-12-16T08:46:19Z |
| format | Article |
| id | doaj.art-2a2bf21152f5486095803d725aeaa373 |
| institution | Directory Open Access Journal |
| issn | 2288-8586 |
| language | English |
| last_indexed | 2024-12-16T08:46:19Z |
| publishDate | 2017-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Maxillofacial Plastic and Reconstructive Surgery |
| spelling | doaj.art-2a2bf21152f5486095803d725aeaa3732022-12-21T22:37:36ZengSpringerOpenMaxillofacial Plastic and Reconstructive Surgery2288-85862017-12-013911610.1186/s40902-017-0136-yHyperpigmentation of the hard palate mucosa in a patient with chronic myeloid leukaemia taking imatinibGian Paolo Bombeccari0Umberto Garagiola1Francesco Pallotti2Margherita Rossi3Massimo Porrini4Aldo Bruno Giannì5Francesco Spadari6Maxillo-Facial and Dental Unit, Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico, University of MilanMaxillo-Facial and Dental Unit, Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico, University of MilanDepartment of Biomedical, Surgical and Dental Sciences, University of MilanMaxillo-Facial and Dental Unit, Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico, University of MilanMaxillo-Facial and Dental Unit, Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico, University of MilanMaxillo-Facial and Dental Unit, Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico, University of MilanMaxillo-Facial and Dental Unit, Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico, University of MilanAbstract Background Imatinib mesylate is an inhibitor of the tyrosine kinase Bcr–Abl and a first-line treatment for Philadelphia chromosome-positive chronic myeloid leukaemia (CML). Dermatological side effects include superficial oedema, pustular eruption, lichenoid reactions, erythroderma, and skin rash. Depigmentation of the skin and/or mucosa is uncommon, and hyperpigmentation is rare. Case presentation We present the case of a 63-year-old Caucasian male with widespread hyperpigmentation of the hard palate associated with a 9-year history of imatinib therapy to treat CML. He did not complain of any symptoms. Clinical examination did not reveal any abnormal pigmentation of the skin or other region of the oral mucosa. He did not smoke cigarettes or drink alcohol. His medication regimen was a proton pump inhibitor, a beta-blocker, cardioaspirin, atorvastatin, and imatinib 400 mg/day. Histopathologically, melanin and haemosiderin deposits were evident in the lamina propria. The lesion persisted, with no clinical change, through several follow-ups. We reviewed the literature to explore the possible relationship between oral hyperpigmentation and long-term imatinib mesylate treatment. Conclusions We diagnosed oral pigmentation associated with imatinib intake based on the medical history and clinical features of the pigmented macules. Oral pigmentation may have a variety of causes, and differential diagnosis requires nodal analysis. Clinicians should be aware of possible oral mucosal hyperpigmentation in patients taking imatinib mesylate. Such pigmentation is benign and no treatment is needed, but surveillance is advisable.http://link.springer.com/article/10.1186/s40902-017-0136-yChronic myeloid leukaemiaOral melanosisDrug-induced oral reactionsOral pigmentationMucosal pigmentation |
| spellingShingle | Gian Paolo Bombeccari Umberto Garagiola Francesco Pallotti Margherita Rossi Massimo Porrini Aldo Bruno Giannì Francesco Spadari Hyperpigmentation of the hard palate mucosa in a patient with chronic myeloid leukaemia taking imatinib Maxillofacial Plastic and Reconstructive Surgery Chronic myeloid leukaemia Oral melanosis Drug-induced oral reactions Oral pigmentation Mucosal pigmentation |
| title | Hyperpigmentation of the hard palate mucosa in a patient with chronic myeloid leukaemia taking imatinib |
| title_full | Hyperpigmentation of the hard palate mucosa in a patient with chronic myeloid leukaemia taking imatinib |
| title_fullStr | Hyperpigmentation of the hard palate mucosa in a patient with chronic myeloid leukaemia taking imatinib |
| title_full_unstemmed | Hyperpigmentation of the hard palate mucosa in a patient with chronic myeloid leukaemia taking imatinib |
| title_short | Hyperpigmentation of the hard palate mucosa in a patient with chronic myeloid leukaemia taking imatinib |
| title_sort | hyperpigmentation of the hard palate mucosa in a patient with chronic myeloid leukaemia taking imatinib |
| topic | Chronic myeloid leukaemia Oral melanosis Drug-induced oral reactions Oral pigmentation Mucosal pigmentation |
| url | http://link.springer.com/article/10.1186/s40902-017-0136-y |
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