Case Reports
31 January 2025
Early Access
A rare vascular manifestation in chronic myeloid leukemia: a case report and literature review of Bier's spot development during nilotinib treatment
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
322
Views
103
Downloads
Authors
Bier's spots are rare angiospastic macules often associated with physiologic vasoconstriction. This case report describes a 35-year-old man with chronic myeloid leukemia treated with nilotinib who developed Bier's spots, a previously unreported adverse effect of the drug. The patient presented with asymptomatic hypopigmented macules on the hands and legs that appeared during venous stasis and resolved with elevation. This case emphasizes the need to recognize potential vascular side effects of tyrosine kinase inhibitors and highlights Bier's spots as a benign but remarkable manifestation in patients undergoing nilotinib therapy.
Altmetrics
Downloads
Download data is not yet available.
Citations
Goldsmith LA, Katz SI, Gilchrest BA, et al., editors. Fitzpatrick's dermatology in general medicine, 8e. New York, NY: The McGraw-Hill Companies; 2012.
Fan YM, Yang YP, Li W, Li SF. Bier spots: six case reports. J Am Acad Dermatol 2009;61:e11-2. DOI: https://doi.org/10.1016/j.jaad.2009.03.009
Bolognia J, Schaffer JV, Cerroni L. Dermatology. Fourth edition ed. [Philadelphia]: Elsevier; 2018.
Gniadecki R, Gniadecka M. Constitutive speckled vascular mottling of the skin resembling Bier white spots: lack of venoarteriolar reflex in dermal arterioles. Arch Dermatol 2000;136:674-5. DOI: https://doi.org/10.1001/archderm.136.5.674-a
Schoenlaub P, Dupré D, Redon JY, Plantin P. Numerous and large Bier's spot associated with pregnancy. Eur J Dermatol 1999;9:230-1.
Sacha T, Saglio G. Nilotinib in the treatment of chronic myeloid leukemia. Future Oncol 2019;15:953-65. DOI: https://doi.org/10.2217/fon-2018-0468
Aichberger KJ, Herndlhofer S, Schernthaner GH, et al. Progressive peripheral arterial occlusive disease and other vascular events during nilotinib therapy in CML. Am J Hematol 2011;86:533-9. DOI: https://doi.org/10.1002/ajh.22037
Manouchehri A, Kanu E, Mauro MJ, et al. Tyrosine kinase inhibitors in leukemia and cardiovascular events: from mechanism to patient care. Arterioscler Thromb Vasc Biol 2020;40:301-8. DOI: https://doi.org/10.1161/ATVBAHA.119.313353
Peyrot I, Boulinguez S, Sparsa A, et al. Bier's white spots associated with scleroderma renal crisis. Clin Exp Dermatol 2007;32:165-7. DOI: https://doi.org/10.1111/j.1365-2230.2006.02298.x
Grosshans E. Multiple anemic macules or Bier's spots? Dermatology 2001;202:272. DOI: https://doi.org/10.1159/000051655
Yıldız H, Saman H. Bier spots on the face: the first case report case report. Trichol Cosmetol Open J 2016;1:8-10. DOI: https://doi.org/10.17140/TCOJ-1-102
Aytekin S. Bier spots on the face: case report. Am J Clin Case Rep 2021;2:1034.
Graham RM, James MP. Exaggerated physiologic speckled mottling of the limbs. Arch Dermatol 1985;121:415-7. DOI: https://doi.org/10.1001/archderm.121.3.415
Dobrev H, Nocheva D. Bier spots - report of two cases and review of the literature. Curr Rheumatol Rev 2018;14:42-5. DOI: https://doi.org/10.2174/1573397113666170615093817
Liaw FY, Chiang CP. Bier spots. CMAJ 2013;185:E304. DOI: https://doi.org/10.1503/cmaj.120376
Esme P, Beksac B, Akoglu G, Caliskan E. Facial Bier spots unresponsive to botulinum toxin: a case series. Dermatol Pract Concept 2023;13. DOI: https://doi.org/10.5826/dpc.1301a32
Mahajan VK, Khatri G, Singh R, et al. Bier spots: an uncommon cause of mottled skin. Indian Dermatol Online J 2015;6:128-9. DOI: https://doi.org/10.4103/2229-5178.153020
Minson AG, Cummins K, Fox L, et al. The natural history of vascular and other complications in patients treated with nilotinib for chronic myeloid leukemia. Blood Adv 2019;3:1084-91. DOI: https://doi.org/10.1182/bloodadvances.2018028035
Wolverton SE, Wu JJ. Comprehensive dermatologic drug therapy. Philadelphia, PA: Elsevier; 2021. Available from: https://www.clinicalkey.com.au/dura/browse/bookChapter/3-s2.0-C20141020972
How to Cite
A rare vascular manifestation in chronic myeloid leukemia: a case report and literature review of Bier’s spot development during nilotinib treatment. (2025). Dermatology Reports. https://doi.org/10.4081/dr.2025.10160
Copyright (c) 2025 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
