Diffuse Plate-Like Sheets of Desquamation in a 69-Year-Old Woman with Relapsed Acute Lymphocytic Leukemia

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.