title: Clinical and histopathologic analysis of 46 cases of cutaneous adverse reactions to imatinib.
abstract: BACKGROUND
  Although many cases of cutaneous adverse reactions to imatinib have been reported, their clinical and histopathologic characteristics are not well documented.
  
  
  OBJECTIVE
  The present study investigated clinical and histopathologic characteristics of cutaneous adverse reactions to imatinib.
  
  
  METHODS
  This retrospective study referred to 46 patients who experienced cutaneous adverse reactions to imatinib. Clinical data including age, sex, skin lesion morphology, underlying disorders, and imatinib treatment parameters (duration of imatinib medication, initial dose, and treatment modifications at the time of the study) were collected. Histopathologic data were available for all patients.
  
  
  RESULTS
  Cutaneous adverse reactions to imatinib developed at 1-24 weeks (median onset: 8 weeks) after imatinib administration. The severity of the reaction was categorized as grade 1 in 22%, grade 2 in 41%, and grade 3 in 37% of patients. Onset was earlier in high-severity reactions than in low-severity reactions. The severity of the reaction was dependent on imatinib dose. Grade 3 reactions were noted in nine of 16 (56%) patients administered "high-dose" (600 mg/d) imatinib. Spongiosis (78% of patients) and papillary dermal edema (83% of patients) were common histopathologic findings in the epidermis and dermis, respectively. Lymphohistiocytes were more predominant than eosinophils in dermal inflammatory infiltration. Histopathologic findings did not differ according to dose of imatinib or severity of the reaction.
  
  
  CONCLUSIONS
  Although the clinical features of cutaneous adverse reactions to imatinib depend on imatinib dose and the severity of the reaction, histopathologic findings are not associated with these clinical variables.
authors.affiliation: Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Chong Hyun
authors.initials: CH
authors.lastname: Won
authors.affiliation: Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Chang
authors.affiliation: Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Jee Ho
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Kee Chan
authors.initials: KC
authors.lastname: Moon
authors.affiliation: Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Yoon-Koo
authors.initials: YK
authors.lastname: Kang
authors.affiliation: Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Mi Woo
authors.initials: MW
authors.lastname: Lee
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D003875:Drug Eruptions / Q000209:etiology* / Q000473:pathology*; D004487:Edema / Q000139:chemically induced*; D004892:Erythema Multiforme / Q000139:chemically induced; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate / Q000008:administration & dosage / Q000009:adverse effects*; D017512:Lichenoid Eruptions / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D010241:Parakeratosis / Q000139:chemically induced; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D000068877:Imatinib Mesylate