Durgin Joseph S, Whittington Carli P, Harrell Jane, Mervak Julie E, Smith Emily H
Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Department of Dermatology, Indiana University, Indianapolis, Indiana, USA.
J Cutan Pathol. 2024 Nov;51(11):860-865. doi: 10.1111/cup.14692. Epub 2024 Jul 17.
Pityriasis rosea is an acute, self-limited exanthem that typically occurs in adolescence and young adulthood, classically featuring ovoid erythematous and scaly lesions on the trunk and proximal extremities. While its cause is not definitively known, the classic form of pityriasis rosea may result from the reactivation of latent human herpesvirus (HHV) infections (HHV-6 and HHV-7). Interestingly, drug eruptions that clinically and/or histopathologically resemble pityriasis rosea have also been reported. These pityriasis rosea-like drug eruptions tend to occur at an older age and have a shorter duration than the classic type. As there are different management paradigms, the distinction between classic pityriasis rosea and the mimicking drug eruption is important to recognize. Herein, we report a case of a pityriasis rosea-like drug eruption that occurred in association with imatinib mesylate treatment for chronic myeloid leukemia. We also review the clinicopathologic features of reported cases of pityriasis rosea-like drug eruption, including those due to imatinib. While the clinical morphology of the cutaneous drug-related eruption mimics the lesions seen in classic pityriasis rosea, the presence of unique histopathologic findings, including necrotic keratinocytes, interface dermatitis, and eosinophils, may aid in distinction.
玫瑰糠疹是一种急性、自限性皮疹,通常发生于青少年和青年时期,典型表现为躯干和四肢近端出现卵圆形红斑鳞屑性损害。虽然其病因尚不明确,但经典型玫瑰糠疹可能是由潜伏的人类疱疹病毒(HHV)感染(HHV - 6和HHV - 7)重新激活所致。有趣的是,临床上和/或组织病理学上类似玫瑰糠疹的药疹也有报道。这些类似玫瑰糠疹的药疹往往发生在年龄较大者,且病程比经典型玫瑰糠疹短。由于存在不同的治疗模式,识别经典玫瑰糠疹与类似的药疹之间的区别很重要。在此,我们报告1例与甲磺酸伊马替尼治疗慢性髓性白血病相关的类似玫瑰糠疹的药疹病例。我们还回顾了已报道的类似玫瑰糠疹药疹病例的临床病理特征,包括因伊马替尼引起的病例。虽然皮肤药物相关皮疹的临床形态与经典玫瑰糠疹所见损害相似,但存在独特的组织病理学表现,包括坏死角质形成细胞、界面性皮炎和嗜酸性粒细胞,可能有助于鉴别。