Unique Cutaneous Reaction to Second- and Third-Generation Tyrosine Kinase Inhibitors for Chronic Myeloid Leukemia

The document described a newly recognized cutaneous reaction to second- and third-generation tyrosine kinase inhibitors (TKIs) used for chronic myeloid leukemia, specifically dasatinib, nilotinib, and ponatinib. Nine patients developed a lichenoid exanthem with erythematous, predominantly follicular papules, scale, and alopecia, resembling follicular lichen planus/lichen planopilaris (LPP) and the rare Graham-Little-Piccardi-Lassueur syndrome. The severe pruritus associated with this reaction could lead to discontinuation of therapy. Clinicians were advised to be aware of these eruptions and the potential therapeutic challenges they present, which might also provide insights into the mechanisms of idiopathic forms of follicular lichen planus.