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Erschienen in: Indian Journal of Hematology and Blood Transfusion 2/2020

10.07.2019 | Images

Imatinib Induced Blue Nails

verfasst von: Ankur Jain

Erschienen in: Indian Journal of Hematology and Blood Transfusion | Ausgabe 2/2020

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Excerpt

A 22-years-old female presented with fatigue for the past 6-months. Examination was remarkable for mild pallor, and hepatosplenomegaly. Blood investigations were: hemoglobin-107 g/l, white cell count: 119 × 109/l, and platelets: 837 × 109/l. Peripheral smear suggested a possibility of myeloproliferative neoplasm. BCR-ABL1 mRNA transcript was detected in the peripheral blood by RT-PCR, confirming the diagnosis of chronic myeloid leukemia. Imatinib (400 mg once a day) was initiated, following which she developed bluish discoloration of the nails of hands and feet after 4-weeks of therapy (Fig. 1). There was no mucocutaneous hyperpigmentation elsewhere. Keeping a possibility of drug-induced hyperpigmentation, imatinib was continued, and patient was reassured. While imatinib-induced hypopigmentation is common (40%), hyperpigmentation is unusual. While nail discoloration due to imatinib has been reported in about 3% cases, isolated nail hyperpigmentation is extremely rare [1]. Postulated mechanisms include paradoxical melanocyte stimulation through c-kit activation, deposition of drug-metabolite chelated to iron or melanin, and drug-induced immune dysregulation leading to melanin pigment incontinence [2]. We highlight the need for a periodic meticulous mucocutaneous examination of patients taking imatinib. Patients with mucocutaneous side effects due to imatinib should be reassured, while continuing the therapy.
Literatur
1.
Zurück zum Zitat Vinay K, Yanamandra U, Dogra S, Handa S, Suri V, Kumari S et al (2018) Long-term mucocutaneous adverse effects of imatinib in Indian chronic myeloid leukemia patients. Int J Dermatol 57:332–338CrossRef Vinay K, Yanamandra U, Dogra S, Handa S, Suri V, Kumari S et al (2018) Long-term mucocutaneous adverse effects of imatinib in Indian chronic myeloid leukemia patients. Int J Dermatol 57:332–338CrossRef
2.
Zurück zum Zitat Di Tullio F, Mandel VD, Scotti R, Padalino C, Pellacani G (2018) Imatinib-induced diffuse hyperpigmentation of the oral mucosa, the skin, and the nails in a patient affected by chronic myeloid leukemia: report of a case and review of the literature. Int J Dermatol 57:784–790CrossRef Di Tullio F, Mandel VD, Scotti R, Padalino C, Pellacani G (2018) Imatinib-induced diffuse hyperpigmentation of the oral mucosa, the skin, and the nails in a patient affected by chronic myeloid leukemia: report of a case and review of the literature. Int J Dermatol 57:784–790CrossRef
Metadaten
Titel
Imatinib Induced Blue Nails
verfasst von
Ankur Jain
Publikationsdatum
10.07.2019
Verlag
Springer India
Erschienen in
Indian Journal of Hematology and Blood Transfusion / Ausgabe 2/2020
Print ISSN: 0971-4502
Elektronische ISSN: 0974-0449
DOI
https://doi.org/10.1007/s12288-019-01159-w

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