ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS SECONDARY TO IMATINIB IN A PATIENT WITH GASTROINTESTINAL STROMAL TUMOR

Background: Imatinib is a tyrosine kinase inhibitor used in the treatment of chronic myeloid leukemias and gastrointestinal stromal tumors. Main Observation: We describe the case of a 64-year-old patient, who had been on imatinib 400 mg / day for a gastrointestinal stromal tumor. He developed one week later a diffuse pustular erythematous pruritic rash associated with an erosive cheilitis. The histological study confirmed the diagnosis of acute generalized exanthematous pustulosis (AGEP). Pharmacovigilance survey concluded that there is a causal link between imatinib and the occurrence of this cutaneous reaction. The causality assessment according to the updated French method was i5 and B3 for the intrinsic and extrinsic causality scores respectively. The evolution after discontinuation of this drug was favorable. The patient was then put on sunitinib with a complete therapeutic response and better tolerance. Conclusion: AGEP secondary to imatinib remains a rare but proven side effect. The outcome is generally favorable but requires the use of other molecules such as sunitinib.