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Dermatological manifestations of malignancies and dermatological emergencies due to malignancy
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
A dermatologist has an important role in the diagnosis of leukemia cutis since it has immense prognostic significance. Leukemia cutis could occur prior to systemic involvement, signify relapse, signify blast transformation, or correlate with other extramedullary sites of involvement.
Mixed Myelodysplastic–Myeloproliferative Neoplasms
Published in Wojciech Gorczyca, Atlas of Differential Diagnosis in Neoplastic Hematopathology, 2014
Based on the number of blasts, CMML is divided into two categories: CMML-1 [<5% blasts in the blood, <10% blasts in the bone marrow (BM)] and CMML-2 (5%–19% blasts in the blood and 10%–19% blasts in the BM). If myelodysplasia is absent or minimal, the diagnosis of CMML may still be made if the other requirements are met, and there is an acquired clonal cytogenetic or molecular abnormality or monocytosis persists for >3 months and all potential secondary causes for monocytosis are excluded (see an algorithmic approach to monocytosis; Figure 33.1). In chronic myeloid leukemia (CML; BCR–ABL1+) and atypical CML (aCML; BCR–ABL1−), monocytes may be increased, but rarely exceed 10% of leukocytes. MDS patients may show occasional monocytosis (even absolute), but they lack chronic and consistent monocytosis typical for CMML. The median age at diagnosis varies between 65 and 75 years, and there is 2:1 male predominance [6,13]. Some patients present with skin lesions due to leukemia cutis (see Chapter 44). Similar to blastic phase (crisis) of CML, some patients with CMML may directly present in the blastic phase [acute myeloid leukemia (AML)]. CMML may occur in patients with mastocytosis and D816V KIT mutation or as a therapy-related CMML following the cytotoxic therapy for nonhematopoietic tumors [14–16].
A case of Norwegian scabies in a patient with leukemia cutis secondary to chronic lymphocytic leukemia
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Skin Biopsy was done eventually which showed spongiotic dermatitis with brisk superficial and deep dermal mononuclear cell infiltrate including eosinophils and an atypical lymphocytic component, consistent with involvement by CLL/SLL. No histologic evidence of superficial infestation by mites (multiple levels through the block examined). There was no evidence of primary vasculitis in any of the specimens. The differential diagnosis of spongiotic dermatitis with a brisk dermal mixed inflammatory infiltrate containing numerous eosinophils includes hypersensitivity reactions, such as a scabies infection, arthropod bite reaction, or a drug reaction. But the presence of the atypical lymphocytic infiltrate was thought to be more consistent with CLL/SLL. This confirmed the diagnosis of Leukemia Cutis.
Combined immunodeficiency with marginal zone lymphoma due to a novel homozygous mutation in IL-21R gene and successful treatment with hematopoietic stem cell transplantation
Published in Pediatric Hematology and Oncology, 2021
Neslihan Edeer Karaca, Gülcihan Özek, Eda Ataseven, Nazan Tökmeci, Handan Duman Şenol, Ezgi Kıran, Ayça Aykut, Asude Durmaz, Güzide Aksu, Serap Aksoylar, Sema Aydoğdu, Nazan Çetingül, Necil Kütükçüler
A six-year-old girl was admitted to our hospital with chronic diarrhea of almost six years of duration. She also had an accompanying generalized skin rash for the past three months. She was the second child of 4th-degree consanguineous parents. She was initially hospitalized at four years of age with prolonged fever and respiratory distress due to CMV pneumonia requiring mechanical ventilation. Immunoglobulin and CD3+ T lymphocyte levels were low for age. She was diagnosed with combined immunodeficiency, antibiotic prophylaxis, and regular intravenous gammaglobulin (IVIG) treatment were initiated. Skin biopsy for the widespread maculopapular rash revealed a diagnosis of leukemia cutis.
Bilateral periorbital leukemia cutis presenting as suspected cellulitis
Published in Orbit, 2022
Lalita Gupta, Melissa A. Levoska, Timmie Sharma, Kord Honda, Mark A. Prendes
Most commonly associated with AML, leukemia cutis occurs when leukemic cells infiltrate the epidermis, dermis or subcutaneous tissue.4,5 Leukemia cutis commonly presents as single or multiple red-brown papulonodules on the legs, arms, or trunk.6 Other clinical variants include hemorrhagic papules, bullae, ulcers, erythema-nodosum-like lesions, subcutaneous nodules similar to panniculitis, and leonine facies.7,8