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2023, Number 4

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Rev Hematol Mex 2023; 24 (4)

Leukemia cutis in the context of acute myeloid leukemia

Santiago BMJ, Ramírez MA, Deffis CM

Language: Spanish
References: 14
Page: 209-213
PDF size: 301.60 Kb.


ABSTRACT

Background: Leukemia cutis is the cutaneous infiltration of neoplastic leukocytes (myeloid or lymphoid) with local flourishing; it is an unusual phenomenon. There are few reports in Mexico, the frequency in the world literature ranges from 2.1 to 30%.
Clinical case: A 61-year-old female patient with a dermatosis with petechiae and papules beginning in the facial region, later generalization, and involvement of the mucous membranes. A skin biopsy of the left thigh was taken with a report of cellular infiltrate in the superficial and mid dermis, composed of lymphocytes and 5% of blasts that expressed CD34, CD117, myeloperoxidase (MPO) and CD38. The findings were consistent with infiltrate by cells of acute myelomonocytic leukemia. Additional tests with complete blood count, peripheral blood smear, and bone marrow biopsy confirmed the diagnosis of acute myelomonocytic leukemia (AMML). She received chemotherapy with 7 + 3 (doxorubicin and cytarabine), as well as intrathecal chemotherapy with methotrexate, cytarabine and dexamethasone and 3 consolidation regimens of high dose cytarabine (HDAC); patient is in complete remission and otherwise healthy.
Conclusions: Skin biopsy is the method of choice for diagnosis, along with immunohistochemical and genetic techniques. These dermatological lesions can precede the diagnosis of leukemia by months or years and influence on timely diagnosis and treatment; hence the particular importance of clinical recognition and early referral.


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