DOI: https://doi.org/10.36347/sjmcr.2026.v14i08.003

Pages: 1766-1769

Imatinib is widely used in the management of chronic myeloid leukemia and is associated with various cutaneous adverse events, most commonly hypopigmentary changes. Hyperpigmentation remains uncommon and may pose diagnostic difficulties, particularly when involving the face. We report the case of a 66-year-old woman treated with imatinib since 2018 who developed progressive, asymptomatic, bilateral blue-violaceous macules coalescing into patches over the temporal regions. Dermoscopy revealed a slate-blue pigmentation with sparse pigmented dots and globules. Skin biopsy showed dermal pigmentary incontinence with melanophages, without features supporting interface dermatitis or ochronosis. The clinical, dermoscopic and histological findings supported imatinib-induced cutaneous hyperpigmentation, and the causal relationship was confirmed by pharmacovigilance assessment. This observation highlights an uncommon pigmentary adverse effect of imatinib and the value of clinicopathological correlation in avoiding misdiagnosis and unnecessary modification of an essential therapy.