Immunohistochemical characterization of cutaneous drug eruptions by STI571

Hyun Jeong Park, Hei Sung Kim, Hee Jung Kim, Jun Young Lee, Baik Kee Cho, Ah Won Lee, Do Young Yoon, Dae Ho Cho

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: STI571, a selective BCR-ABL tyrosine kinase inhibitor, is a promising new drug for chronic myelogenous leukemia (CML). However, the drug has been reported to be associated with adverse cutaneous drug eruptions with high frequency. Objective: In this study, the characteristics of the cutaneous drug eruptions by STI571 were investigated. Methods: The clinical records of 10 patients diagnosed with drug eruption by STI571 were reviewed. We obtained 10 skin biopsy specimens from patients with drug eruption by STI571, 6 from the antibiotics-induced drug eruption group, and 5 from normal skin (control). Immunohistochemical analysis was performed to detect CD4, CD8, CD56, IL-18, IL-1β and ICAM-1 expression in the cutaneous drug eruption. Results: Seven out of 10 patients had maculopapular exanthema, 2/10 erythema multiforme, 1/10 urticaria. We analyzed the composition of T-lymphocyte subsets from the infiltrates at the STI571-induced drug eruption site in eight patients. Unlike other drug eruptions, the increase in the CD8 expression was statistically significant, especially in the dermoepidermal junction and the upper dermis (P < 0.01). The enhanced expression of IL-18 and IL-1β was observed as well. In contrast, ICAM-1 was either weakly positive or negative. Conclusion: Drug eruption caused by STI571 was mostly expressed as a maculopapular exanthema. The histopathological findings were similar in drug eruption by antibiotics or STI571. Unlike the drug eruptions caused by antibiotics, where the expression of CD4 was dominant, CD8 was dominant in drug eruptions by STI571. The expression of IL-18 and IL-1β was increased in both groups. This elevation of IL-18 and IL-1β may assist in understanding the pathogenesis of cutaneous drug eruption.

Original languageEnglish
Pages (from-to)9-15
Number of pages7
JournalJournal of Dermatological Science
Volume38
Issue number1
DOIs
Publication statusPublished - 2005 Jan 1
Externally publishedYes

Fingerprint

Drug Eruptions
Skin
Pharmaceutical Preparations
Interleukin-18
Interleukin-1
Intercellular Adhesion Molecule-1
Anti-Bacterial Agents
Exanthema
Imatinib Mesylate
Erythema Multiforme
Urticaria
T-Lymphocyte Subsets
Dermis
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
T-cells
Biopsy
Protein-Tyrosine Kinases

Keywords

  • CML
  • Drug eruption
  • ICAM-1
  • IL-18
  • IL-1β
  • STI571

ASJC Scopus subject areas

  • Biochemistry
  • Molecular Biology
  • Dermatology

Cite this

Immunohistochemical characterization of cutaneous drug eruptions by STI571. / Park, Hyun Jeong; Kim, Hei Sung; Kim, Hee Jung; Lee, Jun Young; Cho, Baik Kee; Lee, Ah Won; Yoon, Do Young; Cho, Dae Ho.

In: Journal of Dermatological Science, Vol. 38, No. 1, 01.01.2005, p. 9-15.

Research output: Contribution to journalArticle

Park, Hyun Jeong ; Kim, Hei Sung ; Kim, Hee Jung ; Lee, Jun Young ; Cho, Baik Kee ; Lee, Ah Won ; Yoon, Do Young ; Cho, Dae Ho. / Immunohistochemical characterization of cutaneous drug eruptions by STI571. In: Journal of Dermatological Science. 2005 ; Vol. 38, No. 1. pp. 9-15.
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abstract = "Background: STI571, a selective BCR-ABL tyrosine kinase inhibitor, is a promising new drug for chronic myelogenous leukemia (CML). However, the drug has been reported to be associated with adverse cutaneous drug eruptions with high frequency. Objective: In this study, the characteristics of the cutaneous drug eruptions by STI571 were investigated. Methods: The clinical records of 10 patients diagnosed with drug eruption by STI571 were reviewed. We obtained 10 skin biopsy specimens from patients with drug eruption by STI571, 6 from the antibiotics-induced drug eruption group, and 5 from normal skin (control). Immunohistochemical analysis was performed to detect CD4, CD8, CD56, IL-18, IL-1β and ICAM-1 expression in the cutaneous drug eruption. Results: Seven out of 10 patients had maculopapular exanthema, 2/10 erythema multiforme, 1/10 urticaria. We analyzed the composition of T-lymphocyte subsets from the infiltrates at the STI571-induced drug eruption site in eight patients. Unlike other drug eruptions, the increase in the CD8 expression was statistically significant, especially in the dermoepidermal junction and the upper dermis (P < 0.01). The enhanced expression of IL-18 and IL-1β was observed as well. In contrast, ICAM-1 was either weakly positive or negative. Conclusion: Drug eruption caused by STI571 was mostly expressed as a maculopapular exanthema. The histopathological findings were similar in drug eruption by antibiotics or STI571. Unlike the drug eruptions caused by antibiotics, where the expression of CD4 was dominant, CD8 was dominant in drug eruptions by STI571. The expression of IL-18 and IL-1β was increased in both groups. This elevation of IL-18 and IL-1β may assist in understanding the pathogenesis of cutaneous drug eruption.",
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AU - Kim, Hei Sung

AU - Kim, Hee Jung

AU - Lee, Jun Young

AU - Cho, Baik Kee

AU - Lee, Ah Won

AU - Yoon, Do Young

AU - Cho, Dae Ho

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AB - Background: STI571, a selective BCR-ABL tyrosine kinase inhibitor, is a promising new drug for chronic myelogenous leukemia (CML). However, the drug has been reported to be associated with adverse cutaneous drug eruptions with high frequency. Objective: In this study, the characteristics of the cutaneous drug eruptions by STI571 were investigated. Methods: The clinical records of 10 patients diagnosed with drug eruption by STI571 were reviewed. We obtained 10 skin biopsy specimens from patients with drug eruption by STI571, 6 from the antibiotics-induced drug eruption group, and 5 from normal skin (control). Immunohistochemical analysis was performed to detect CD4, CD8, CD56, IL-18, IL-1β and ICAM-1 expression in the cutaneous drug eruption. Results: Seven out of 10 patients had maculopapular exanthema, 2/10 erythema multiforme, 1/10 urticaria. We analyzed the composition of T-lymphocyte subsets from the infiltrates at the STI571-induced drug eruption site in eight patients. Unlike other drug eruptions, the increase in the CD8 expression was statistically significant, especially in the dermoepidermal junction and the upper dermis (P < 0.01). The enhanced expression of IL-18 and IL-1β was observed as well. In contrast, ICAM-1 was either weakly positive or negative. Conclusion: Drug eruption caused by STI571 was mostly expressed as a maculopapular exanthema. The histopathological findings were similar in drug eruption by antibiotics or STI571. Unlike the drug eruptions caused by antibiotics, where the expression of CD4 was dominant, CD8 was dominant in drug eruptions by STI571. The expression of IL-18 and IL-1β was increased in both groups. This elevation of IL-18 and IL-1β may assist in understanding the pathogenesis of cutaneous drug eruption.

KW - CML

KW - Drug eruption

KW - ICAM-1

KW - IL-18

KW - IL-1β

KW - STI571

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