Leukemia Cutis
From Anvita Health Wiki
Contents |
Introduction
- Localized or disseminated skin infiltration by leukemic cells.
Etiology
- skin infiltration by leukemic cells
- occurs with both acute & chronic leukemias
- most commonly occurs in association with AML-M4 & M5
Epidemiology
- <5% to 50% of leukemias, depending upon type
- any age, but more common in patients > 50 years
- no sex predilection
Clinical-manifestations
- skin lesions may precede onset of systemic leukemia
- lesions generally arise over several days
- lesions are generally asymptomatic, but may be pruritic, tender or painful
- most common lesions are small 2-5 mm papules, nodules or plaques (always palpable)
- a variety of lesion morphologies are associated with each specific leukemia
- lesions are generally somewhat darker than surrounding skin, pink -> brown -> violaceous
- lesions may be hemorrhagic in patients with thrombocytopenia
- generalized distribution of lesions, especially trunk, extremities & face
- gingival infiltration may occur with acute monocytic leukemia ( AML-M5)
- less common manifestations:
- ecchymoses, palpable purpura, ulcerative lesions, erythroderma, bullous lesions, gingival hypertrophy, arciform lesions, lesions resembling pyoderma gangrenosum, urticaria, urticaria pigmentosa, Guttate psoriasis
Laboratory
-
- touch preparation
- immunohistochemistry ( immunophenotyping)
Complications
Differential-diagnosis
- disseminated infection
- inflammatory disorders
- drug reaction
- transfusion-associated graft vs. host reaction
- vasculitis
- erythema multiforme
Management
More General Terms
References
Color Atlas & Synopsis of Clinical Dermatology, Common & Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY, 1997, pg 566-569
