Sustained improvement in urticaria pigmentosa and pruritus in a case of indolent systemic mastocytosis treated with cladribine.

Abstract

Systemic mastocytosis (SM) is a myeloproliferative disorder, characterized by a clonal proliferation of abnormal mast cells accumulating in internal organs and sometimes in the skin, leading to cutaneous and systemic symptoms. Mutations within the gene KIT, which encodes the receptor tyrosine kinase (KIT) on mast cells, is found in most patients with SM. We report a case of a 62-year-old woman presenting with a pruritic rash on her limbs and trunk. Several years later she developed gastrointestinal symptoms, associated with raised serum tryptase. Skin and bone marrow biopsies confirmed a diagnosis of SM, initially presenting with urticaria pigmentosa. Responses to multiple therapies, including potent topical steroids, oral antihistamines, phototherapy and the tyrosine kinase inhibitor, nilotinib, were inadequate. Treatment with cladribine (2-chlorodeoxyadenosine) produced a marked and sustained reduction in her symptoms and serum tryptase level.

• Authors: A D Lock, C J McNamara, M H A Rustin
• Journal: Clinical and experimental dermatology (Clin Exp Dermatol) Vol. 40 Issue 2 Pg. 142-5 (Mar 2015) ISSN: 1365-2230 [Electronic] England
• PMID: 25515765 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2014 British Association of Dermatologists.

Chemical References

• Immunosuppressive Agents
• Cladribine

Topics

• Cladribine (therapeutic use)
• Female
• Humans
• Immunosuppressive Agents (therapeutic use)
• Mastocytosis, Systemic (drug therapy)
• Middle Aged
• Pruritus (drug therapy)
• Treatment Outcome
• Urticaria Pigmentosa (drug therapy)