A Case of Inflammatory Nonscarring Alopecia Associated With the Tyrosine Kinase Inhibitor Nilotinib

Abstract

Importance: Nilotinib, a recently approved multitargeted tyrosine kinase inhibitor targeting the BCR-Abl translocation involved in chronic myelogenous leukemia, reportedly produces alopecia according to the package insert, but clinical and histologic descriptions of the alopecia are lacking. Observations: A 33-year-old woman with chronic myelogenous leukemia developed widespread alopecia involving scalp and body hair within weeks after starting nilotinib therapy. Biopsies revealed perifollicular lymphocytic inflammation and evidence of follicular injury but normal hair density, consistent with a nonscarring alopecia. Conclusions and Relevance: Nilotinib therapy may induce perifollicular inflammation and widespread persistent alopecia. We present the first clinical and histologic description of this potential adverse effect. Further investigation into the underlying mechanism of this adverse effect may produce insights into the hair growth cycle as well as potential therapeutic targets.

Generalized keratosis pilaris‐like eruptions in a chronic myelogenous leukemia patient treated with nilotinib

“…Nilotinib preferentially inhibits the BCR-ABL tyrosine kinase but has also been shown to interact with the discoidin domain receptors, platelet-derived growth factor receptor and c-kit receptor. 3 Although the mechanism underlying the keratosis pilaris-like eruptions that occur in response to nilotinib is largely unknown, nilotinib may modulate the tyrosine kinase receptor in hair follicles. On the other hand, keratosis pilarislike eruptions in response to RAF inhibitor, vemurafenib and dabrafenib have also been reported.…”

“…2 Previous reports also have identified HPV-124 in the oral cavity of a healthy volunteer. 3 However, little is known about the pathogenicity of HPV-124. This viral wart had existed untreated for more than…”

Nilotinib-induced keratosis pilaris associated with alopecia areata and eyebrow thinning

“…[ 2 3 ] This targeted therapy has been approved for treatment of Philadelphia chromosome–positive CML and involved in numerous skin adverse reactions. [ 1 ] Although to the best of our knowledge, only eight cases of nilotinib-induced KP have been reported, none of which are associated with alopecia areata and eyebrows thinning.…”

“…The second-generation Bcr-Abl TKI nilotinib has been implicated in multiple skin eruptions, especially pruritic erythematous and maculopapular exanthemas (the majority of which being transient and autoresolutive) as well as Lichenoid eruptions. [ 1 ] Herein, we report a unique case of nilotinib-induced keratosis pilaris (KP) with diffuse eyebrow thinning and autoresolutive alopecia areata plaque of the wrist.…”

Detection of human papillomavirus type 124 in a viral wart located on a thigh

“…2 Previous reports also have identified HPV-124 in the oral cavity of a healthy volunteer. 3 However, little is known about the pathogenicity of HPV-124. This viral wart had existed untreated for more than 10 years with no sign of tissue neoplasia or dysplasia.…”