Imatinib mesylate induced pityriasis rubra pilaris like rash

Abstract

Pityrisis Rubra Pilaris (PRP) is an inflammatory keratinisation disorder with unknown etiology characterized by orange-red erythema, circumscribed keratosis, and branny scales, and palmoplantar keratoderma. There have been very few case reports which suggest drugs as an inciting or triggering factor for PRP. Imatinib is a Tyrosine Kinase inhibitor that is being used in several diseases notably chronic myeloid leukemia ( CML) and Gastrointestinal stromal tumors (  GIST). In this case report, we described a diagnosed case of CML with ABL-BCR positivity on oral Imatinib 400mg who developed generalized erythema with an orange hue and follicular keratosis with islands of normal skin. She was diagnosed as a case of PRP clinically and dermoscopically.  Imatinib was stopped and she was started on 40 mg steroids which were tapered and stopped. The rash subsided in 1 week subsequently and did not recur in 6 months.