Ponatinib
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Cerebral infarction and ichthyosiform eruption with facial erythema: case report A 70-year-old woman developed cerebral infarction and ichthyosiform eruption with facial erythema during treatment with ponatinib for acute lymphoblastic B leukaemia [route not stated; not all durations of treatment to reactions onsets and outcomes stated] The woman with a 3-year history of acute lymphoblastic B leukaemia presented with slowly spreading, pruritic and erythematous dermatosis for two months. She had previously received imatinib and dasatinib for leukaemia, but complete remission was not achieved. Thus ponatinib 30 mg/day was initiated 3 months prior to the presentation. During the presentation physical examination showed diffuse facial erythema on cheeks and part of the neck, along with coalescing erythematous patches with dry, rough, hyperpigmented, brownish scales, especially on the extremities, with less intense involvement of the trunk. Keratoderma was not identified. She did not have any abnormalities in the hair, nails or mucosa. Histological examination showed effacement of the rete ridges, mostly orthokeratosis with focal parakeratosis, and a very thin granular layer. The symptoms were consistent with acquired ichthyosis. Thus, she was diagnosed with ichthyosiform eruption with facial erythema secondary to ponatinib treatment. The woman received urea and wool-fat [lanolin] ointment and the ponatinib treatment was continued. After 20 days of treatment, partial clearance of the eruption was achieved. However, she developed new neurological symptoms i.e. cognitive impairment and generalised tremor secondary to cerebral infarction. The ischaemic event was attributed to ponatinib. Thus, ponatinib was discontinued. Later, she did not experience recurrence of the skin eruption. Munera-Campos M, et al. Ichthyosiform eruption and facial erythema secondary to ponatinib therapy. Journal der Deutschen Dermatologischen Gesellschaft 18: 743-747, No. 7, Jul 2020. Available from: URL: http://doi.org/10.1111/ddg.14154 803498221
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Reactions 29 Aug 2020 No. 1819
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