Wen-Shan Chen
Taichung Veterans General Hospital, Taiwan
Title: Imatinib-induced pemphigus foliaceus in a patient with gastrointestinal stromal tumor
Biography
Biography: Wen-Shan Chen
Abstract
A 59-year-old man was diagnosed one-year-ago with a gastrointestinal stromal tumor (GIST) and liver metastasis. Since the diagnosis, he has been under an oral, Imatinib 400 mg daily treatment without any concomitant medications or special health food. A half year into the treatment, he was presented to our dermatology clinic due to progressing, non-pruritic scaly eroded eruptions over his upper back and abdomen. An incisional skin biopsy taken from the lesion over his back revealed a subcorneal cleft with acantholysis, along with dyskeratotic cells in the granular layer of the epidermis. Direct immunofluorescence revealed remarkable intercellular deposits of both immunoglobulin G (IgG) and C3 within the upper epidermis, but without the deposits of IgM and IgA. Indirect immunofluorescence showed circulating IgG anti-intercellular substance antibodies at a titer of 1:160. A careful correlation between the clinical and pathologic pictures suggested a diagnosis of Imatinib-induced pemphigus foliaceus (PF). In summary, to the best of our knowledge, this is the ï¬rst case of Imatinib-induced PF ever reported in literature. We strongly believe that any observation of scaly, erytheamtous maculopapules in patients under Imatinib treatment should alarm the caring physicians, in light of the increasing popularity of prescribing this novel anticancer drug.