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Ambrogio F, Poli MA, Lospalluti L, Lettini T, Cassano N, Vena GA, Ingravallo G, Cazzato G, Foti C. Keratosis Pilaris-like Eruption during Treatment of Chronic Myeloid Leukemia with Tyrosine Kinase Inhibitors: Literature Review and Report of a Case Related to Imatinib. J Clin Med 2023; 13:32. [PMID: 38202039 PMCID: PMC10779630 DOI: 10.3390/jcm13010032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/10/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
The advent of tyrosine kinase inhibitors (TKIs) blocking BCR-ABL activity has revolutionized the therapeutic management of patients with chronic myeloid leukemia (CML). Adverse cutaneous reactions (ACRs) are common nonhematologic adverse events associated with the use of BCR-ABL TKIs. A characteristic pattern of eruption resembling keratosis pilaris (KP) has been described in patients treated with these drugs, especially nilotinib and dasatinib. The pathogenesis of this ACR is still unknown. This type of reaction appears to be uncommon with imatinib. Here, we report the case of an elderly patient with an asymptomatic KP-like eruption, which appeared one month after starting treatment with imatinib for CML. The case presentation is accompanied by a review of similar reactions in patients with CML treated with BCR-ABL inhibitors, attempting to make an excursus on the molecular targets of such drugs and possible mechanisms underlying this ACR.
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Affiliation(s)
- Francesca Ambrogio
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (F.A.); (M.A.P.); (L.L.); (C.F.)
| | - Melita Anna Poli
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (F.A.); (M.A.P.); (L.L.); (C.F.)
| | - Lucia Lospalluti
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (F.A.); (M.A.P.); (L.L.); (C.F.)
| | - Teresa Lettini
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (T.L.); (G.I.)
| | - Nicoletta Cassano
- Dermatology and Venereology Private Practice, 76121 Barletta, Italy; (N.C.); (G.A.V.)
| | - Gino Antonio Vena
- Dermatology and Venereology Private Practice, 76121 Barletta, Italy; (N.C.); (G.A.V.)
| | - Giuseppe Ingravallo
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (T.L.); (G.I.)
| | - Gerardo Cazzato
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (T.L.); (G.I.)
| | - Caterina Foti
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (F.A.); (M.A.P.); (L.L.); (C.F.)
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Alkhayal FA, Bin Fadliah R, Alasgah S, Almutiri R, alqubaisy Y. Generalized keratosis pilaris induced by testosterone injections in a patient with CHARGE syndrome. Dermatol Reports 2023; 15:9661. [PMID: 37426363 PMCID: PMC10327667 DOI: 10.4081/dr.2023.9661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 07/11/2023] Open
Abstract
Keratosis pilaris (KP) is a common disorder of follicular keratinization characterized by keratotic follicular papules with varying degrees of perifollicular erythema. Keratosis pilaris affects up to half of normal children and up to three-quarters of children with atopic dermatitis. KP is prominent during adolescence and less common in older people, but it may occur in children and adults of all ages. In this report, we describe the case of a 13-year-old boy known to have CHARGE syndrome who developed generalized keratosis pilaris after testosterone injections. To the best of our knowledge, this is the first reported case of generalized keratosis pilaris induced by testosterone injection.
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Affiliation(s)
| | - Rima Bin Fadliah
- Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sarah Alasgah
- Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Raed Almutiri
- Dermatology and Dermatologic Surgery Department, Prince Sultan Military Medical City, Riyadh
| | - Yasser alqubaisy
- Dermatology and Dermatologic Surgery Department, Prince Sultan Military Medical City, Riyadh
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Bayazit S, Aşkın Ö, Kutlubay Z. Comparative study of the efficacy of Fractional Er: YAG 2940 nm laser and Q-switched Nd: YAG 1064 nm laser in keratosis pilaris. J Cosmet Dermatol 2022; 21:3809-3813. [PMID: 35770308 DOI: 10.1111/jocd.15193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/16/2022] [Accepted: 06/26/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Keratosis pilaris is a common keratinization disorder of the extensor surfaces of the proximal extremities. Various treatment modalities reduce symptoms, but their efficacy is limited. AIMS The aim of this study is to compare the efficiency of Q-Switched Nd: YAG laser and fractional Er: YAG laser. MATERIAL/METHOD The lesions in both arms were randomly divided into areas A and B. Fractional Er: YAG 2940 nm laser performed to area A 1.5 joules/cm2, spot size 7 mm, frequency 3 Hz and three passes and Q-Switched Nd: YAG 1064 nm laser performed to Area B, 4-6 joules/cm2 spot size 4 mm, 8 Hz frequency, and as a single pass. Both lasers were performed in 4 sessions at 3-week intervals. The global improvement scale evaluated treatment responses in dyspigmentation and skin texture. RESULTS Twenty patients completed the study, and the mean age of a total of 20 patients was 22.9. There was no significant difference in dyspigmentation and skin texture with global improvement scale between Area A and Area B, respectively ( p=0.078, p=0.638). In addition, there was no significant difference between patient satisfaction levels after treatment in Area A and Area B (p=0.868). CONCLUSION The efficiency of the fractional Er: YAG 2940 nm laser was found equal to the Q-switched Nd: YAG 1064 nm laser. Fractional Er: YAG 2940 nm laser may be a new treatment option in the treatment of keratosis pilaris.
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Affiliation(s)
- Samet Bayazit
- Cerrahpaşa Medical Faculty, Department of Dermatology and Venerology, University-Cerrahpaşa, İstanbul, Turkey
| | - Özge Aşkın
- Cerrahpaşa Medical Faculty, Department of Dermatology and Venerology, University-Cerrahpaşa, İstanbul, Turkey
| | - Zekayi Kutlubay
- Cerrahpaşa Medical Faculty, Department of Dermatology and Venerology, University-Cerrahpaşa, İstanbul, Turkey
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Reddy S, Brahmbhatt H. A Narrative Review on the Role of Acids, Steroids, and Kinase Inhibitors in the Treatment of Keratosis Pilaris. Cureus 2021; 13:e18917. [PMID: 34692268 PMCID: PMC8528166 DOI: 10.7759/cureus.18917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 01/01/2023] Open
Abstract
Keratosis pilaris is a common and benign genetic skin disorder that results in patches of rough bumps on the skin, with varying degrees of reddening and inflammation. These bumps in the skin are caused by the dead skin cells that plug the hair follicles. Keratosis pilaris often manifests in small, hard bumps on the legs and arms. A common treatment method for many acne conditions, including keratosis pilaris, is acid, which has shown promise in recent years. This review examines the use and success of multiple types of acids, steroids, and kinase inhibitors in clinical and non-clinical settings to treat and understand keratosis pilaris. In the treatment of keratosis pilaris, acid primarily works by breaking down the dead skin cells that clog the hair follicles. Some types of steroids have anti-inflammatory properties that have proven useful in minimizing the appearance of acne. Kinase inhibitors control important skin cell functions, such as cell signaling, metabolism, division, and survival, which undoubtedly affect the appearance of skin as a whole. The known impact of acid, steroids, and kinase inhibitors on keratosis pilaris is underestimated and should be given more attention by healthcare industry leaders.
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Lahouel I, Ben Salah N, Rouatbi J, Boukhriss S, Abdejlil N, Youssef M, Belhadjali H, Laatiri A, Zili J. Nilotinib-induced lichen planopilaris. Int J Dermatol 2021; 61:e37-e38. [PMID: 33937983 DOI: 10.1111/ijd.15647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/16/2021] [Accepted: 04/13/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Ines Lahouel
- Dermatology Department, Dermo-Respiratory Research Laboratory UR14 SP 03, Fattouma Bourguiba Hospital, University of Medicine, Monastir, Tunisia
| | - Nesrine Ben Salah
- Dermatology Department, Dermo-Respiratory Research Laboratory UR14 SP 03, Fattouma Bourguiba Hospital, University of Medicine, Monastir, Tunisia
| | - Jacem Rouatbi
- Dermatology Department, Dermo-Respiratory Research Laboratory UR14 SP 03, Fattouma Bourguiba Hospital, University of Medicine, Monastir, Tunisia
| | - Sarra Boukhriss
- Hematology Department, Fattouma Bourguiba Hospital, University of Medicine, Monastir, Tunisia
| | - Nouha Abdejlil
- Anatomopathology Department, Fattouma Bourguiba Hospital, University of Medicine, Monastir, Tunisia
| | - Monia Youssef
- Dermatology Department, Dermo-Respiratory Research Laboratory UR14 SP 03, Fattouma Bourguiba Hospital, University of Medicine, Monastir, Tunisia
| | - Hichem Belhadjali
- Dermatology Department, Dermo-Respiratory Research Laboratory UR14 SP 03, Fattouma Bourguiba Hospital, University of Medicine, Monastir, Tunisia
| | - Adnene Laatiri
- Hematology Department, Fattouma Bourguiba Hospital, University of Medicine, Monastir, Tunisia
| | - Jameledin Zili
- Dermatology Department, Dermo-Respiratory Research Laboratory UR14 SP 03, Fattouma Bourguiba Hospital, University of Medicine, Monastir, Tunisia
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Toriyama M, Ishii KJ. Primary Cilia in the Skin: Functions in Immunity and Therapeutic Potential. Front Cell Dev Biol 2021; 9:621318. [PMID: 33644059 PMCID: PMC7905053 DOI: 10.3389/fcell.2021.621318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/04/2021] [Indexed: 12/21/2022] Open
Abstract
The skin is the biggest organ and provides a physical and immunological barrier against pathogen infection. The distribution of primary cilia in the skin of mice has been reported, but which cells in human skin have them has not, and we still know very little about how they change in response to immune reactions or disease. This review introduces several studies that describe mechanisms of cilia regulation by immune reaction and the physiological relevance of cilia regulating proliferation and differentiation of stroma cells, including skin-resident Langerhans cells. We discuss the possibility of primary cilia pathology in allergic atopic dermatitis and the potential for therapies targeting primary cilia signaling.
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Affiliation(s)
- Manami Toriyama
- Graduate School of Pharmacological Sciences, Osaka University, Osaka, Japan.,Center for Vaccine and Adjuvant Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan.,Graduate School of Science and Technology, Nara Institute of Science and Technology, Nara, Japan
| | - Ken J Ishii
- Center for Vaccine and Adjuvant Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan.,Laboratory of Vaccine Science, World Premier International Research Center Initiative (WPI) Immunology Frontier Research Center, Osaka University, Osaka, Japan.,Division of Vaccine Science, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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Koh XQ, Ooi XT, Sun Y, Chandran NS, Tan CL. A retrospective analysis of dermatological problems in haematology and oncology patients at a tertiary Singapore hospital. Australas J Dermatol 2020; 61:e474-e476. [DOI: 10.1111/ajd.13328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 04/12/2020] [Accepted: 04/13/2020] [Indexed: 01/03/2023]
Affiliation(s)
- Xuan Qi Koh
- Department of Dermatology National University Health System National University Hospital Singapore Singapore
| | - Xue Ting Ooi
- Department of Dermatology National University Health System National University Hospital Singapore Singapore
| | - Yang Sun
- Department of Dermatology National University Health System National University Hospital Singapore Singapore
| | - Nisha Suyien Chandran
- Department of Dermatology National University Health System National University Hospital Singapore Singapore
| | - Chris Lixian Tan
- Department of Dermatology National University Health System National University Hospital Singapore Singapore
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Radhika S, Hongal A, Revathi TN, Shilpa K. Myriads of cutaneous manifestations with Nilotinib, treated by acitretin – a case report. INDIAN JOURNAL OF DRUGS IN DERMATOLOGY 2020. [DOI: 10.4103/ijdd.ijdd_13_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mir-Bonafé J, Saceda-Corralo D, Vañó-Galván S. Adverse Hair Reactions to New Targeted Therapies for Cancer. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Mir-Bonafé J, Saceda-Corralo D, Vañó-Galván S. Reacciones capilares de las nuevas terapias diana dirigidas contra el cáncer. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:182-192. [DOI: 10.1016/j.ad.2018.10.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 09/27/2018] [Accepted: 10/13/2018] [Indexed: 12/16/2022] Open
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Wang JF, Orlow SJ. Keratosis Pilaris and its Subtypes: Associations, New Molecular and Pharmacologic Etiologies, and Therapeutic Options. Am J Clin Dermatol 2018; 19:733-757. [PMID: 30043128 DOI: 10.1007/s40257-018-0368-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Keratosis pilaris is a common skin disorder comprising less common variants and rare subtypes, including keratosis pilaris rubra, erythromelanosis follicularis faciei et colli, and the spectrum of keratosis pilaris atrophicans. Data, and critical analysis of existing data, are lacking, so the etiologies, pathogeneses, disease associations, and treatments of these clinical entities are poorly understood. The present article aims to fill this knowledge gap by reviewing literature in the PubMed, EMBASE, and CINAHL databases and providing a comprehensive, analytical summary of the clinical characteristics and pathophysiology of keratosis pilaris and its subtypes through the lens of disease associations, genetics, and pharmacologic etiologies. Histopathologic, genomic, and epidemiologic evidence points to keratosis pilaris as a primary disorder of the pilosebaceous unit as a result of inherited mutations or acquired disruptions in various biomolecular pathways. Recent data highlight aberrant Ras signaling as an important contributor to the pathophysiology of keratosis pilaris and its subtypes. We also evaluate data on treatments for keratosis pilaris and its subtypes, including topical, systemic, and energy-based therapies. The effectiveness of various types of lasers in treating keratosis pilaris and its subtypes deserves wider recognition.
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Affiliation(s)
- Jason F Wang
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 240 East 38th Street, 11th Floor, New York, NY, 10016, USA
| | - Seth J Orlow
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 240 East 38th Street, 11th Floor, New York, NY, 10016, USA.
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Chang CH, Shih LY, Lu PH. A case of nilotinib-induced keratosis pilaris-like perifollicular fibrosis with a brief review of the literature. DERMATOL SIN 2017. [DOI: 10.1016/j.dsi.2017.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Tawil MH, El Khoury R, Tomb R, Ghosn M. Nilotinib-induced Keratosis Pilaris Associated with Alopecia Areata and Eyebrow Thinning. Int J Trichology 2017; 9:87-89. [PMID: 28839396 PMCID: PMC5551315 DOI: 10.4103/ijt.ijt_1_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Tyrosine kinase enzymes are an attractive target for anticancer therapies. Tyrosine kinase inhibitors (TKI) are well tolerated; somehow severe systemic side effects are rarely seen during treatment. Toxicities of skin and appendages may lead to poor compliance, psychosocial inconvenience, and drug interruption. Changes of the hair can arise following cures with TKI. Nilotinib, a second-generation TKI, has been responsible for various cutaneous side effects including different clinical presentations of alopecia (scarring and nonscarring forms). This paper reports the case of a 45-year-old male diagnosed with chronic myelogenous leukemia (CML) treated with nilotinib, who presented with a keratosis pilaris (KP)-like eruption, autoresolutive alopecia areata plaque of the wrist and diffuse eyebrow thinning. To date, eight cases of nilotinib-induced KP were reported. However, none of them was associated with alopecia areata. Hence, physicians need to be aware of this new cutaneous side effect and investigating the reason of this phenomenon requires additional studies.
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Affiliation(s)
- Maya Halabi Tawil
- Department of Dermatology, School of Medicine, Saint-Joseph University, Hotel Dieu de France University Hospital and Medical Center, Beirut, Lebanon
| | - Rana El Khoury
- Department of Dermatology, School of Medicine, Saint-Joseph University, Hotel Dieu de France University Hospital and Medical Center, Beirut, Lebanon
| | - Roland Tomb
- Department of Dermatology, School of Medicine, Saint-Joseph University, Hotel Dieu de France University Hospital and Medical Center, Beirut, Lebanon
| | - Marwan Ghosn
- Department of Oncology and Hematology, School of Medicine, Saint-Joseph University, Hotel Dieu de France University Hospital and Medical Center, Beirut, Lebanon
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