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Dasatinib & the sun

Hi

I just wondered if anyone else on dasatinib (or any other TKI) has any skin reactions to the sun?! 

My hands have come up in a red, 'blistery' type rash which feels like sunburn - especially when I put my hands in warm/hot water. They look truly awful!

I have suffered with this before and this weekend the dreaded rash has returned - coincidental, so has the sun! The rash is nowhere else though - just my hands and occasionally it appears on my feet! I can only assume that it is a reaction with the sun and dasatinib as nothing else in my diet & lifestyle has changed. I never had it before my diagnosis and didn't have it when I was on imatinib.

Last year I was referred to a dermatologist but by the time I actually saw him, it was autumn and the rash wasn't there for him to see! I have been prescribed some steroid cream to put on them but it doesn't really help. I'm also trying to keep a high factor suncream on them - one consultant I saw last year advised me to wear gloves to keep my hands out of the sun - fashionistas beware - swimwear and gloves is not a great combo!!

I just wondered if anyone else has experienced the same and if so, have you found anything to help. I'm going abroad for the Easter holidays and worried my hands will get worse.

Rachael x

 

Hi

I've only been using Dasatinib for6 weeks, but very quickly after starting I got a light rash on the skin at the top of my cheek bones - it felt slightly leathery. The top of my head became quite sore, I believe this was as a result of being out in the sun for no more than about 30 minutes. The cheekbone rash and scalp felt exactly like it was sunburn, as you describe, but I think it's a lot milder than you have. It took about a week staying out of the sun before it stopped being irritating. I have a tendency for spots now in my scalp. This is all new.

I now use factor 30 whenever exposed to the sun for a significant period, and managed to go skiing in bright sunshine for 3 days with little sign of photo-sensitivity using the sun block on my face.hands/head. I kept my scalp mostly covered. My hands are ok, (although rather pale!), but have not had much sun exposure.

The skin rash was helped by using Diprobase cream which you can get over the counter at Boots for about £12, or on prescription.

I always use rubber gloves when washing up, and haven't had any hand reaction to washing them /showering.

I hope this helps.

Rod

It's difficult to know whether it's linked but I feel that my skin has become much more reactive to sunlight since being on Dasatanib for 2.5 years. I've never had particularly tanning skin, but in the past few years just a short time in the sun- a 20 minute bike ride, or even a short car journey- and my skin starts to burn.

It's not such a bother as I just need to slap on some spray- there are some very unobtrusive ones available- but it makes trips to the beach and long walks in the sun more complicated...

ADJL

are these (2) forearm images recognizable to anyone here on dasatinib?

https://photos.app.goo.gl/TbDn5zELKjLxu36j9

thanks

 

 

I’ve been taking Dasatanib for 9 months and I had the exact same symptoms/rash on my hands in the summer. It has gone away in the winter. I don’t think the steroid cream helps at all. 

Dasatinib is a tyrosine kinase inhibitor specifically designed to target CML cells which produce excess tyrosine kinase.

However, the skin depends on other tyrosine kinases to regulate melanin production. Dasatinib can impact these tyrosine kinases as well.

This can lead to skin difficulty protecting itself against sun exposure naturally through melanin production and tan development.

People who suffer rashes after taking dasatinib especially after sun exposure (and sun burn easily) should consider dasatinib dose modification to lessen the impact and/or avoid the sun as much as possible. Adequate vitamin D can help lessen the suns impact on the skin. The skin synthesizes vitamin D as one of the ways to protect the skin from UV damage.

In my own case, I did notice I would not tan easily whille I was taking dasatinib, but once I stopped, tanning was quick. I never developed rashes, but I took a much lower dasatinib dose than most patients (20 mg.).

Dasatinib is potent and relatively short lived in the body. The least amount of drug which works is best. More drug does not necessarily provide better CML response and can, instead, increase side effects such as skin issues. Talk to your doctor about your skin issues and see if dose modification is warranted. If you do lower your dose, you must test PCR more frequently to see your response trend. If your response is maintained (and in some case - it might actually improve!, then you may be able to avoid the rashes as well as tan. If not, then avoiding the sun is best.

Oh yeah, a small walk outside and my face is lobster red. No blisters though... but obvious rednerss. I wouldn't call it sun-burn though. I've had bad sun-burns before, but this is unlike that, more like some sort of a photo-sensitivity.

I got overexposed in the sun today in London.

It was 15 degrees Celsius with a UV index of 3 and I have a red face and neck. The UV index goes up to 11 and 3 is the lowest end of “moderate”. Even with all my years of CML I didn’t think this would cause an issue (and I checked UV beforehand). I was outside for no more than 30 or 40 minutes as I was walking between places on our day out and even then much of that time in shade. Harrods to the Natural History Museum and back.

I take only 20mg of dasatinib.

Sun exposure on dasatinib is no joke. Though I am just a little pink it has given me a good reminder how important it is to be aware of the sun when on these meds.

David.

Harrods to the Natural History museum (best gem/mineralogy exhibit in the world) ..... I so miss that walk. One of my favorite strolls and then over to Hyde Park and up to south Kensington for some pasta at Da Mario's.

With two 4 year olds you can only imagine I didn’t get a moment to look at any mineralogy, but instead was rammed into the dino hall where twin 2 was terrified of the animatronic T-Rex!

And Harrods was closed! Despite living in London for 20 years I never realised everything closes on Easter Sunday (but thankfully not the pubs).