Abstract
Background: Imatinib, a tyrosine kinase inhibitor targeting bcr-abl, c-Kit, and PDGF receptors-alpha and beta, is commonly used to treat GI stromal tumors and hematologic malignancies. Hyperpigmentation is a known side-effect of imatinib, with intradermal hemosiderosis being the most common histologic finding.
 Case Presentation: We report a rare case of concurrent hypopigmentation and hyperpigmentation secondary to dermal melanocytosis following imatinib treatment in an African American patient with acute lymphoblastic leukemia.
 Conclusion: Early referral to dermatology in patients with similar findings is appropriate given the increased risk of melanoma conferred by heightened melanocyte proliferation.
Highlights
CASE PRESENTATIONImatinib, a tyrosine kinase inhibitor, is commonly used to treat gastrointestinal stromal tumors and hematologic malignancies.[1]
We report a rare case of hyperpigmented patches secondary to dermal melanocytosis following imatinib treatment in an African American patient with acute lymphoblastic leukemia (ALL)
An 81-year-old African American woman with a history of ALL presented to dermatology clinic with diffuse hyperpigmented patches of her face, upper back, and shoulders in February of 2020
Summary
CASE PRESENTATIONImatinib, a tyrosine kinase inhibitor, is commonly used to treat gastrointestinal stromal tumors and hematologic malignancies.[1]. A tyrosine kinase inhibitor, is commonly used to treat gastrointestinal stromal tumors and hematologic malignancies.[1] Cutaneous reactions occur in up to 69% of patients, most commonly manifesting as superficial edema and an exanthem-like rash.[2] Recent literature documents changes in pigmentation, with higher rates of hypopigmentation (40.9%) as compared to hyperpigmentation (3.6%).[3] While the histologic appearance of imatinibinduced hyperpigmentation varies, intradermal hemosiderosis is the most common finding.[4] We report a rare case of hyperpigmented patches secondary to dermal melanocytosis following imatinib treatment in an African American patient with acute lymphoblastic leukemia (ALL).
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