Cutaneous leukaemic infiltrations in a patient with previously undiagnosed myelodysplastic syndrome
ABSTRACT We report the rare case of a patient with leukaemia cutis first presenting only on the hand and fingers and then subsequently spreading over the trunk and face. The lesions heralded the transformation of a previously undiagnosed myelodysplastic syndrome type RAEB (refractory anaemia with blast excess) into frank myeloid leukaemia. The haematological disease was first detected by the dermatohistopathologist. This case underlines the need to look meticulously for skin changes and perform early skin biopsies in haematological patients, as the skin can reveal the first clinical signs of an otherwise not evident bone marrow disorder. Leukaemia cutis as the initial clinical presentation of a transforming myelodysplastic syndrome type RAEB into acute myeloid leukaemia has been reported only very rarely.
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ABSTRACT: We report a case of leukaemia cutis presenting as stasis dermatitis-like eruption in a patient with myelodysplastic syndrome progressing to acute myelogenic leukaemia.Clinical and Experimental Dermatology 06/2008; 33(3):298-300. DOI:10.1111/j.1365-2230.2007.02655.x · 1.23 Impact Factor
Chapter: Leukemia Cutis[Show abstract] [Hide abstract]
ABSTRACT: The diagnosis and classification of leukemia requires the integration of clinical features and light microscopic findings with the results of cytochemical, immunological (flow cytometry and/or immunohistochemistry), and molecular studies . Immunophenotypic and genotypic technologies are commonly applied to peripheral blood (PB) and bone marrow (BM) specimens in the initial work-up and management of patients with leukemia. It is critical to definitively characterize the disease, due to differences in treatment regimens and prognosis among leukemia subtypes . Skin lesions that may arise in patients with leukemia can be divided into two groups: (a) “leukemids” or nonspecific reactions, in which inflammatory lesions contain no neoplastic cells; and (b) leukemia cutis (LC) or specific lesions, in which leukemic cells (myeloid or lymphoid) infiltrate the skin [2, 3]. Commonly used terms for LC composed of myeloid blasts include chloroma, extramedullary myeloid sarcoma, granulocytic sarcoma, and monoblastic sarcoma [1, 3]. This chapter discusses some of the limitations of traditional methodologies, and potential applications of molecular technologies, in the diagnosis and follow-up of patients with LC.Molecular Diagnostics in Dermatology and Dermatopathology, 03/2011: pages 263-281;