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患者因服用帕纳替尼而出现斑丘疹和苔藓样皮肤损伤。

A patient with maculopapular rash and lichenoid skin damage caused by ponatinib.

机构信息

Department of Pharmacology, Haukeland University Hospital, N-5021 Bergen, Norway.

Department of Pathology, Haukeland University Hospital, N-5021 Bergen, Norway.

出版信息

J Int Med Res. 2020 Apr;48(4):300060520903660. doi: 10.1177/0300060520903660.

Abstract

Tyrosine kinase inhibitors (TKIs) are invaluable for the treatment of patients with chronic myelogenous leukemia. Although TKIs are generally better tolerated than traditional chemotherapy, dermatologic side effects are common and present a significant cause of concern for both patients and physicians. Ponatinib is a third-generation TKI and the only kinase inhibitor effective in patients with certain mutations, including the T315I mutation. However, ponatinib is associated with an increased risk of serious side effects, and severe cutaneous reactions have increasingly been reported. We present a patient who developed a cutaneous lichenoid eruption following the initiation of ponatinib, which resolved after treatment with a topical retinoid. This case demonstrates that cutaneous side effects caused by ponatinib can be managed relatively easily, allowing patients to continue treatment with ponatinib. This is important considerting the limited alternative treatment approaches available for T315I chronic myelogenous leukemia.

摘要

酪氨酸激酶抑制剂(TKIs)在治疗慢性髓性白血病患者方面具有重要价值。尽管 TKI 通常比传统化疗更耐受,但皮肤副作用很常见,是患者和医生都非常关注的问题。帕纳替尼是一种第三代 TKI,是唯一对包括 T315I 突变在内的某些突变有效的激酶抑制剂。然而,帕纳替尼与严重副作用的风险增加相关,严重的皮肤反应也越来越多地被报道。我们报告了 1 例患者在开始使用帕纳替尼后发生了皮肤苔藓样疹,经局部维 A 酸治疗后缓解。该病例表明,帕纳替尼引起的皮肤副作用相对容易处理,使患者能够继续接受帕纳替尼治疗。考虑到对于 T315I 慢性髓性白血病可用的替代治疗方法有限,这一点很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c83f/7132818/b6ff6fdd12ce/10.1177_0300060520903660-fig1.jpg

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