Dasatinib is an oral second-generation multitarget tyrosine-kinase inhibitor (TKI) that is efficacious in treating imatinib-resistant chronic myeloid leukemia (CML) or intolerant cases. Noncutaneous adverse effects with dasatinib are well known in the literature, most commonly cytopenias and fluid retention, while pigmentary abnormalities have rarely been reported. We report the case of a 12-year-old male known case of CML, who presented to dermatology clinic approximately 2 years after initiating dasatinib treatment, with new-onset hypopigmentation of his upper limb, upper chest, and both knees of six months' duration.

BackgroundSystemic lupus erythematosus (SLE) is a multi-system autoimmune disease which most commonly presents in women of reproductive age. It takes a relapsing-remitting course and may manifest as a variety of clinical symptoms, making it difficult to diagnose at first presentation, particularly in the emergency department (ED) setting. In active SLE, rhabdomyolysis has, thus far, not been reported as the sole initial presentation.Case presentationA 28-year-old presented to the ED with bilateral proximal arm swelling and pain. She had a previous history of Raynaud’s disease. Creatine kinase was > 13,000 units/l (normal range 25–200), but renal function was preserved. She did not require hospital admission so was encouraged to take oral fluids and discontinue the combined oral contraceptive pill. Antinuclear antibody and anti-double-stranded DNA titres were highly elevated with low complement demonstrated. She was diagnosed with SLE and treated with an oral prednisolone course. Antibody titres remained high 6 months later, provoking the initiation of hydroxychloroquine therapy.ConclusionsWe report with a view to recommend autoimmune screening in young patients for whom a cause of rhabdomyolysis is not clearly identified.

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The Down syndrome (DS) is the well-known trisomy, which is caused by additional copy ofchromosome 21.There are three types of DS. First, fully trisomy (47,XY,+21or 47,XX,+21).Second, translocation DS which result as translocation between chromosome 14 and21(46,XY,trans (14:21) or (46,XX,trans (14:21)). And the third type the mosaic DS that two celllines present in the individual. Mostly, studies indicate that frequency of each type 95%, 4% and1% respectively. Our study aims to estimate the frequency of each of the three types of DSchromosomal abnormalities in Iraqi samples. Chromosomal analysis using G-band technique wasperformed for 200 Down syndrome cases and 168 of their parents (whenever there were mosaicDS cases their parents were submitted chromosomal analysis). Fifty-seven percentage of caseswere fully Trisomy, forty-three percentage of them were mosaic DS, and no translocation patternwas recorded. The maternal ages were between 25-45 for the mosaic DS mothers. According tothis study, the frequency of mosaic DS was varied. It seems more investigations need to be donefor larger number of DS, and the impact of environmental changes in last decades need to bestudied more to be sure of its role in increasing of the proportion of this type of Down syndrome.