Lichen planopilaris-like eruption during treatment with tyrosine kinase inhibitor nilotinib

Abstract

Tyrosine kinase inhibitors are effective as a target therapy for malignant neoplasms. Imatinib was the first tyrosine kinase inhibitor used. After its introduction, several other drugs have appeared with a similar mechanism of action, but less prone to causing resistance. Even though these drugs are selective, their toxicity does not exclusively target cancer cells, and skin toxicity is the most common non-hematologic adverse effect. We report an eruption similar to lichen planopilaris that developed during therapy with nilotinib, a second generation tyrosine kinase inhibitor, in a patient with chronic myeloid leukemia resistant to imatinib. In a literature review, we found only one report of non-scarring alopecia due to the use of nilotinib.

Adnexotropic Variants of the Interface Dermatitides: A Review

“…In addition, adnexotropic lichenoid drug reactions have also been reported in patients receiving receptor tyrosine kinase inhibitors. A lichen planopilaris-like presentation has been observed with a perifollicular lymphocytic infiltrate being described in these patients [31,32].…”

Imatinib-induced classical lichen planopilaris in blaschko-linear distribution leading to cicatricial alopecia

“…However, nilotinib-induced lichen planopilaris have been described on one occasion, where the patient developed lichen planopilaris–like lesions on arms within six weeks of therapy, although our patient had classical morphology. [ 3 ] In a case series of nine patients with CML, initially, six patients were on imatinib therapy and three were started on dasatinib (one) and nilotinib (two). Five out of six patients on imatinib, developed resistance and one developed nondermatologic intolerance.…”

Lichen planopilaris related to imatinib therapy with good response to oral doxycycline

“…It has been described in association with other tyrosine kinase inhibitors as sunitinib, sorafenib, nilotinib, pazopanib, and with the inhibitor of epidermal growth factor receptor erlotinib. 2,3 There are few cases reported and clinical and histologic features are incompletely described. 4,5 LPP is a relatively uncommon cutaneous disorder that leads to selective destruction of hair follicles, thus resulting in scarring alopecia.…”

“…Alba Calleja Algarra 1,2,3 Raquel Aragón Miguel 1,2,3 Virginia Velasco Tamariz 1,2,3 Cristina Vico Alonso 1,2,3 Belén Pinilla Martínez 1,2,3 José Luis Rodríguez Peralto 2,3,4 Pablo L. Ortiz Romero 1,2,3 Fátima Tous Romero 1,2,3 1 Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain 2 Intitute I+12, Madrid, Spain…”