Article

Pyoderma gangrenosum as an Early Revelator of Acute Leukemia

Universitair Ziekenhuis Ghent, Gand, Flemish, Belgium
Dermatology (Impact Factor: 1.57). 02/2000; 200(2):176-8. DOI: 10.1159/000018360
Source: PubMed

ABSTRACT

Bullous pyoderma gangrenosum is an atypical, more superficial variety of the classical pyoderma and is often associated with myeloproliferative disorders. We present the case of a patient who presented initially with subcutaneous nodules and who developed bullous lesions afterwards. Histological evaluation showed the presence of neutrophilic infiltrates in both lesions. A few months after the diagnosis of bullous pyoderma gangrenosum, an underlying leukemia was revealed. Our case illustrates the importance of regular blood and bone marrow examinations in patients with atypical bullous pyoderma gangrenosum, resulting in a rapid diagnosis of the underlying disease.

0 Followers
 · 
9 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: An 18-year-old female patient with acute myelogenous leukemia (AML) M2 was treated between March and June 1998 with idarubicin, cytarabine, busulfan and cyclophosphamide. In June 1998, an autologous hematopoietic peripheral blood stem cell transplant was performed. The patient was asymptomatic without treatment until January 1999, when a relapse of AML was observed. In March 1999, when the patient was waiting for another allogenic hematopoietic transplantation, she presented to the Department of Dermatology, Clinica Universitaria Puerta de Hierro, Madrid, with an acute onset a few days previously of macular, slightly elevated. irregular patches with ill-defined borders, confined to the anterior aspect of the trunk in a bilateral distribution. especially on both breasts (Fig. 1). The eruption was asymptomatic. The patient had not received any treatment of any kind in the preceding weeks before the appearance of the cutaneous lesions. She had received a blood transfusion 3 weeks previously. The patient also had a low-grade fever (37.8 degreesC). Laboratory investigations showed pancytopenia and a slight elevation of hepatic enzymes. The rest of the parameters were within the normal range. Blood cultures were negative. Histologic examination of a biopsy specimen taken from a cutaneous lesion showed a normal epidermis, a dermis with a sparse interstitial neutrophilic infiltrate, and a dense inflammatory infiltrate composed almost exclusively of neutrophils in and around the secretory portion of the eccrine glands (Fig.2). The presence of necrotic epithelial cells was remarkable. Immunohistochemical techniques and special staining for bacteria or fungi did not provide any additional data. The cutaneous eruption disappeared spontaneously in 2 weeks. An allogenic hematopoietic transplantation was performed. The patient died on day +27 due to hepatic and pulmonary complications.
    No preview · Article · Mar 2001 · International Journal of Dermatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 33-year-old woman developed a bullous PG precursing a chronic myelomonocytic leukemia (CMML) complicated by life-threatening, disseminated, intravascular coagulation after administration of systemic corticosteroids in combination with immunosuppressant and antibiotic agents. Although the association between PG and leukemia, as well as the coincidence of disseminated intravascular coagulation (DIC) and leukemia, is well known, a premonitoring effect of PG in combination with DIC preceding the diagnosis of chronic myelomonocytic leukemia in the same patient has not been reported recently.
    No preview · Article · Feb 2003 · The Journal of Dermatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Collaboration between specialists is necessary for good practice of medicine. The dermatological examination, mainly based on visual characteristics, can greatly help other specialisms when confronted with a seemingly futile skin anomaly. We discuss the various cutaneous features of some metabolic and infectious diseases, the pitfalls in diagnosing lupus erythematosus without knowledge of skin disease and the relationship of dermatological diseases as cutaneous vasculitis, pyoderma gangrenosum, Sweet's syndrome, pemphigus and more to internal disease.
    No preview · Article · Sep 2003 · Acta clinica Belgica
Show more