Poplausky Dina, Young Jade N, Dubin Danielle P, Tremblay Douglas, Gulati Nicholas
Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA.
Division of Hematology and Medical Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA.
Cureus. 2023 Sep 21;15(9):e45697. doi: 10.7759/cureus.45697. eCollection 2023 Sep.
Dasatinib is a second-generation tyrosine inhibitor that is used for the treatment of patients with chronic myeloid leukemia (CML). It can cause a myriad of skin toxicities, including pruritis, pigmentary abnormalities of hair and skin, and maculopapular rashes. Rarely, it can be associated with acneiform eruptions, which are typically treated with doxycycline. However, doxycycline may not be an ideal therapy, especially for long-term use, due to the risk of gut flora disruption, antimicrobial resistance, and side effects. We present a case of a CML patient who developed an acneiform eruption associated with dasatinib and was successfully treated with sarecycline, a narrow-spectrum tetracycline. Given its targeted spectrum of activity, sarecycline has a lower risk of antimicrobial resistance and an improved safety profile compared to first- and second-generation tetracyclines such as doxycycline. As acneiform drug eruptions can have a significant impact on a patient's quality of life, effective management by dermatologists is paramount. Sarecycline may be a suitable treatment with a favorable safety profile, making it an appropriate choice for patients, especially those who require long-term therapy.
达沙替尼是一种第二代酪氨酸抑制剂，用于治疗慢性髓性白血病（CML）患者。它可引起多种皮肤毒性，包括瘙痒、毛发和皮肤色素异常以及斑丘疹。罕见情况下，它可与痤疮样皮疹相关，痤疮样皮疹通常用多西环素治疗。然而，由于存在肠道菌群破坏、抗菌药物耐药性和副作用的风险，多西环素可能不是理想的治疗方法，尤其是长期使用时。我们报告一例CML患者，该患者出现了与达沙替尼相关的痤疮样皮疹，并成功接受了窄谱四环素类药物丝丽环素的治疗。鉴于其靶向活性谱，与多西环素等第一代和第二代四环素相比，丝丽环素具有较低的抗菌药物耐药性风险和更好的安全性。由于痤疮样药物疹可对患者的生活质量产生重大影响，皮肤科医生进行有效管理至关重要。丝丽环素可能是一种安全性良好的合适治疗方法，使其成为患者的合适选择，尤其是那些需要长期治疗的患者。
