Krygier J, Leemans G, Forsyth R, de Becker A, Gutermuth J, Grosber M
Service de dermatologie, Universitair Ziekenhuis Brussel, (UZ Brussel), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, Bruxelles, Belgique.
Service d'anatomie pathologique, Universitair Ziekenhuis Brussel, (UZ Brussel), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, Bruxelles, Belgique.
Ann Dermatol Venereol. 2018 Nov;145(11):665-670. doi: 10.1016/j.annder.2018.04.009. Epub 2018 Jun 11.
Pityriasis rubra pilaris (PRP) is a cutaneous syndrome of unknown origin. Most cases are sporadic and acquired. Herein we report a fifth case of PRP-like eruption associated with ponatinib, a tyrosine kinase inhibitor (TKI).
A 60-year-old woman presented at the dermatology department with an erythemato-squamous eruption present for 2weeks. The patient was also being treated in haematology for recurrence of acute lymphoblastic leukaemia. Treatment with ponatinib had been initiated 6weeks earlier. Despite the low specific cutaneous histology, a diagnosis of induced PRP-like eruption was made based on the characteristic clinical aspect. Treatment with local corticosteroids resolved the eruption.
The literature contains 6 reported cases of PRP-like eruptions associated with TKI, including 4 with ponatinib. The eruption began from 2weeks to 2-3 months after treatment induction. Prescribed topical corticosteroids have yielded mixed results. A better understanding of the physiopathology of these eruptions associated with TKI could shed light on the pathogenic mechanisms in relation to idiopathic PRP.
红皮病型毛发红糠疹（PRP）是一种病因不明的皮肤综合征。大多数病例为散发性且后天获得性。在此，我们报告第五例与酪氨酸激酶抑制剂（TKI）波纳替尼相关的PRP样皮疹病例。
一名60岁女性因出现红斑鳞屑性皮疹2周就诊于皮肤科。该患者同时因急性淋巴细胞白血病复发正在血液科接受治疗。6周前开始使用波纳替尼治疗。尽管皮肤组织学特异性较低，但基于特征性临床表现诊断为诱发性PRP样皮疹。局部使用糖皮质激素治疗使皮疹消退。
文献报道了6例与TKI相关的PRP样皮疹病例，其中4例与波纳替尼有关。皮疹在治疗开始后2周 至2 - 3个月出现。外用糖皮质激素治疗效果不一。更好地了解这些与TKI相关皮疹的生理病理学，可能有助于揭示特发性PRP的发病机制。
