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Neutrophilic Dermatosis Secondary to Imatinib Therapy in a Patient with CML: A Case Report
Author(s) -
Ayirookuzhi S.J.,
Ma L,
Ramshesh P.,
Mills G.
Publication year - 2005
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2005.0320n.x
Subject(s) - medicine , dermis , hyperpigmentation , skin biopsy , imatinib mesylate , biopsy , pathology , imatinib , sweet's syndrome , sweet syndrome , dermatology , myeloid leukemia
A 53 year old woman with CML in the chronic phase received therapy with Imatinib on two separate occasions. Both occasions were followed by the development of an abrupt onset of skin lesions characterized by painful and tender erythematous plaques and nodules on the upper extremities that subsequently resolved with hyperpigmentation. The patient was also found to have pleural and pericardial effusions. She had a WBC count of 57,250 cells per mm 3 , a platelet count of 740,000 per mm 3 and a single temperature spike of 100.4 °F. Over the course of a week the WBC count dropped to 51,520 cells per mm 3 but the percent of mature neutrophils rose to 55%. Imatinib was discontinued and steroid therapy led to resolution of the skin lesions with residual pigmentation. A skin biopsy was obtained that showed neutrophilic dermatosis with epidermal sparing consistent with Sweet's syndrome but with atypical features such as extension into deep dermis and subcutaneous fat. Lab work up including blood cultures and bacterial, fungal and mycobacterial cultures of the skin as well as special stains of the skin biopsy specimen failed to reveal any microbiological etiology.