TLDR The rash resolved after stopping ponatinib.
A 69-year-old woman with relapsed acute lymphocytic leukemia developed a diffuse, asymptomatic scaly rash 15 days after starting inotuzumab ozogamicin and ponatinib. The rash, characterized by thick plate-like sheets of desquamation, did not improve with prednisone and triamcinolone but resolved upon discontinuation of ponatinib. Histopathology suggested drug-induced acquired ichthyosis, a rare condition associated with medications like ponatinib. Systemic retinoids, specifically oral acitretin, are recommended for refractory cases, although they should be used cautiously due to potential liver enzyme abnormalities.
32 citations,
September 2015 in “Dermatology” Certain leukemia drugs can cause severe skin reactions that may require stopping treatment.
April 2023 in “Journal of Investigative Dermatology” New method measures skin cell turnover quickly and effectively, showing turnover slows with age and responds more to treatments in older skin.
6 citations,
December 2018 in “The American Journal of Dermatopathology” Early shedding of the inner root sheath in noninflamed hair follicles is a relatively specific sign of Central Centrifugal Cicatricial Alopecia.
146 citations,
May 2002 in “The American journal of pathology” Cathepsin L is essential for normal hair growth and development.
87 citations,
March 2014 in “Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids” Cholesterol sulfate buildup due to a genetic mutation disrupts the skin barrier, leading to the scaling skin seen in X-linked ichthyosis.
49 citations,
July 1994 in “British journal of dermatology/British journal of dermatology, Supplement” Some children with methylmalonic and propionic acidaemias have skin problems related to their condition and diet.
