Multiple Keratoacanthomas, Philadelphia Chromosome+ Acute Lymphoblastic Leukemia, and Dasatinib: A Case Report
Background: Treatment for adult Philadelphia chromosome+ acute lymphoblastic leukemia includes using dasatinib, a tyrosine kinase inhibitor. Cutaneous squamous cell carcinomas and keratoacanthomas are common findings in patients treated with BRAF inhibitors of tyrosine kinases. No documentation of dasatinib inducing multiple keratoacanthomas, squamous cell carcinomas type during treatment of Philadelphia chromosome+ acute lymphoblastic leukemia is currently available. Case: A 77-year-old Caucasian male presented to the dermatology clinic two months after starting treatment with dasatinib for Philadelphia chromosome positive+ acute lymphoblastic leukemia. Biopsies confirmed the lesions on the arms, chest, legs and back as keratoacanthoma (KA) type of squamous cell carcinomas (SCCs). The cutaneous lesions were surgically removed and no new or recurrent lesions were detected since their initial rapid onset despite continued dasatinib therapy. Conclusion: This report of the rapid onset of keratoacanthoma type squamous cell carcinomas in a patient with Philadelphia chromosome+ acute lymphoblastic leukemia treated with dasatinib is presumed to be the first due to the rarity of adult Philadelphia chromosome+ acute lymphoblastic leukemia. This report documents another tyrosine kinase inhibitor that is associated with the eruption of keratoacanthomas, and adds to the literature regarding the regularity of this relatively common side effect, which may have treatment other than surgery if only a few lesions are present.
2. Pui CH, Evans WE. Acute lymphoblastic leukemia. N Engl J Med. 1998 Aug 27;339(9):605-15.
3. Talpaz M, Shah NP, Kantarjian H, Donato N, Nicoll J, Paquette R, et al. N Engl J Med. 2006 Jun 15;354(24):2531-41.
4. Hoelzer D, Gökbuget N, Ottmann O, Pui CH, Relling MV, Appelbaum FR, et al. Acute lymphoblastic leukemia. Hematology Am Soc Hematol Educ Program. 2002:162-92.
5. Peters P, Rabbolini D, Sinnya S, Khosrotehrani K, Wagner G. Multiple squa¬mous cell carcinomas following introduction of nilotinib. Clin Exp Dermatol. 2014 Oct;39(7):791-4.
6. Fielding AK. Current treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia. Haematologica. 2010 Jan;95(1):8-12.
7. Hawrot A, Alam M, Ratner D. Squamous cell carcinoma. Curr Probl Derma¬tol.2003 May-Jun;15(3):91-133.
8. Ra SH, Su A, Li X, Zhou J, Cochran AJ, Kulkarni RP, et al. Keratoacanthoma and squamous cell carcinoma are distinct from a molecular perspective. Mod Pathol. 2015 Jun;28(6):799-806.
9. Su F, Viros A, Milagre C, Trunzer K, Bollag G, Spleiss O, et al. RAS mutations in cutaneous squamous-cell carcinomas in patients treated with BRAF inhibi¬tors. N Engl J Med. 2012 Jan 19;366(3):207-15.
10. Arnault JP, Wechsler J, Escudier B, Spatz A, Tomasic G, Sibaud V, et al. Kera¬toacanthomas and squamous cell carcinomas in patients receiving sorafenib. J Clin Oncol. 2009 Aug 10;27(23):e59-61.
11. Smith KJ, Haley H, Hamza S, Skelton HG. Eruptive keratoacanthoma-type squamous cell carcinomas in patients taking sorafenib for the treatment of solid tumors. Dermatol Surg. 2009 Nov;35(11):1766-70.
12. Graubert TA. A call to action for acute lymphoblastic leukemia. N Engl J Med. 2014 Sep 11;371(11):1064-6.
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