Related Experiment Video
Updated: Jun 4, 2026
Using a 1064-nm Picosecond Neodymium-Doped Yttrium Aluminum Garnet Laser for Periorbital Hyperpigmentation
Published on: May 23, 2025
Oral pigmentation in the hard palate associated with imatinib mesylate therapy: a report of three cases
U Mattsson1, S Halbritter, E Mörner Serikoff
1Clinic of Oral and Maxillofacial Surgery, Central Hospital, Karlstad, Sweden. ulf.mattsson@liv.se
Abstract:
Imatinib mesylate is a tyrosine kinase inhibitor which targets Bcr-Abl-protein, c-Kit, and platelet-derived growth factor receptor. The drug was originally developed for treatment of chronic myeloid leukemia but is also regarded as first-line treatment of patients with metastatic gastrointestinal stromal tumours (GIST). Dermatologic side effects are common, with superficial edema and rash as the most frequent. In addition, imatinib mesylate treatment is often associated with hypopigmentation. Intraoral side effects are very rare. The present paper demonstrates 1 patient with GIST and 2 patients with chronic myeloid leukemia treated with imatinib mesylate for 5-6 years. All 3 patients presented with diffuse solitary bluish-brown pigmentations in the hard palate. The lesions persisted at follow-ups. There were no other pigmentations in the oral mucosa. The histopathologic examination showed depositions of melanin pigment in the lamina propria. The possible relationship between the observed melanotic maculae and imatinib mesylate treatment is discussed.
Insights
Imatinib mesylate, used for chronic myeloid leukemia and GIST, can cause rare oral side effects. Three patients developed bluish-brown hard palate pigmentations, identified as melanin deposits, suggesting a link to long-term imatinib treatment.
Area of Science:
- Oncology
- Pharmacology
- Oral Medicine
Background:
- Imatinib mesylate is a tyrosine kinase inhibitor targeting Bcr-Abl, c-Kit, and PDGF-R.
- It is a standard treatment for chronic myeloid leukemia (CML) and metastatic gastrointestinal stromal tumors (GIST).
- Common side effects include dermatologic issues like edema and rash, and hypopigmentation; intraoral effects are rare.
Observation:
- This paper reports on three patients (1 GIST, 2 CML) treated with imatinib mesylate for 5-6 years.
- All patients presented with diffuse, solitary bluish-brown pigmentations on the hard palate.
- No other oral mucosal pigmentations were observed, and lesions persisted during follow-up.
Findings:
- Histopathologic examination revealed melanin pigment deposition in the lamina propria of the affected palate areas.
- These findings suggest the development of melanotic maculae associated with long-term imatinib mesylate therapy.
Implications:
- This study highlights a rare but persistent intraoral side effect of imatinib mesylate.
- It suggests a potential link between imatinib treatment and the development of oral melanotic maculae.
- Further research is warranted to understand the mechanism and clinical significance of this phenomenon.
