Xanthelasma palpebrarum: a new side effect of nilotinib

Abstract

Chronic myeloid leucaemia (CML) is a chronic myeloproliferative disorder characterised by a reciprocal translocation between the chromosomes 9 and 22 resulting in constitutionally active tyrosine kinase signalling. BCR-ABL tyrosine kinase inhibitors (TKIs) are highly effective molecules in the treatment of CML. Unfortunately, these novel therapeutic agents are accompanied by various side effects, and haematological, cutaneous and metabolic abnormalities are among the most prevalent. Nilotinib, a second-generation TKI, has been shown to cause both—cutaneous lesions and lipid profile abnormalities. We present two CML cases developing xanthelasma palpebrarum while receiving nilotinib. Case 1 also acquired a lipid abnormality following the start of nilotinib therapy, while case 2 meanwhile stayed normolipidemic. In addition to a low cholesterol diet, atorvastatin was prescribed to case 1. Currently, both cases are normolipidemic and continuing their nilotinib therapy. Xanthelasma palpebrarum secondary to nilotinib therapy is new to the literature.

The Significance of Extracellular Cholesterol Crystals or a Cholesterol Granuloma in Xanthelasma

“…Extremely rare lesions are tumoral, elevated masses [16], and patients with autosomal dominant familial hypercholesterolemia may have multiple plaques [4]. Nilotinib, an antileukemic drug, can induce xanthelasma formation [17]. Corneal arcus senilis is associated with xanthelasmas in 20% of cases [13].…”

Nilotinib-induced confluent and reticulated papillomatosis in a patient with chronic myeloid leukemia

“…A thorough search of literature reveals various reportings of cutaneous adverse effects associated with the intake of nilotinib, summarised in Table 1. [3][4][5][6] e mechanism of the cutaneous reaction in our case is possibly attributed to c-kit (one of the targets of TKIs) as it is also expressed in the basal skin cells and melanocytes, apart from the cancer cells.…”