Presentation
Our patient died 5 weeks following initial presentation. [mdedge.com]
The section Cases presents brief case reports that convey clear, practical lessons. Preference is given to common presentations of important rare conditions, and important unusual presentations of common problems. [cmaj.ca]
@article{732a1d02ab9142baa3aa8e0406897136, title = "Rare case of leukemia cutis presenting as erythroderma in a patient with acute myeloid leukemia", keywords = "acute myeloid leukemia, cutaneous leukemia, erythroderma, exfoliative dermatitis, leukemia [scholars.northwestern.edu]
Presentation may precede (aleukemic LC), coincide with, or manifest as recurrence of acute leukemia Most cases present after diagnosis of systemic leukemia < 10% present prior to blood or bone marrow involvement (aleukemic LC or primary extramedullary [basicmedicalkey.com]
Case Presentation: A 49‐year‐old man presented with a diffuse, nontender, nonpruritic papular exanthem. He stated that it started on the chest and spread to his back and extremities. [shmabstracts.com]
Respiratoric
- Dyspnea
Because of the lack of healthy blood cells, affected individuals may experience weakness, fatigue, shortness of breath (dyspnea), recurrent infections (which can cause fever, body aches, and night sweats), and prolonged bleeding. [rarediseases.org]
His dyspnea was classified by the New Aplastic anemia is a heterogenous group of blood disorders resulting in pancytopenia and hypocellular bone marrow due to bone marrow failure. [splithatchet.com]
Gastrointestinal
- Nausea
Fever, chills, lethargy Enlarged liver and spleen: nausea, abdominal fullness, constipation. Swollen lymph glands. Central nervous system: cranial nerve palsies, stroke, seizures, headache, loss of sensation. [dermnetnz.org]
Side Effects Nausea, vomiting, constipation, lightheadedness, dizziness, or drowsiness may occur. Gadalla, M. If the degree of anemia is significant, Surgery is a very hard taskmaster, or mistress. Case report. [splithatchet.com]
- Vomiting
Side Effects Nausea, vomiting, constipation, lightheadedness, dizziness, or drowsiness may occur. Gadalla, M. If the degree of anemia is significant, Surgery is a very hard taskmaster, or mistress. Case report. [splithatchet.com]
Cardiovascular
- Hypertension
A 45-year-old man with a past medical history of hypertension and depression presented with a 2-month history of progressive generalized bone pain, fever, chills, night sweats, unintentional weight loss and easy bruising, and a 4-day history of bilateral [nature.com]
The patient had no history of medical systemic disease, with the exception of hypertension. Furthermore, there was no history of fever, trauma, weight loss, bleeding or any systemic illness. However, the patient was a chronic alcoholic. [spandidos-publications.com]
Most patients, as was the case in this patient, die within a few months from the time of histological diagnosis.[6,7] Case Report A 46-year-old man with a history of hypertension, hyperlipidemia, and depression presented with a two-week history of fatigue [jcadonline.com]
- Heart Failure
This can lead to several health issues such as heart failure, stroke, bleeding, or infection. 00 / 0 votes)Rate this definition: Plastic. Plastics are typically organic polymers of high molecular mass, but they often contain other substances. [splithatchet.com]
Skin
- Cutaneous Manifestation
In addition, an extensive section deals with the many and varied nonspecific cutaneous manifestations of this group of diseases. [annals.org]
Abstract Leukemia cutis (LC), a rare cutaneous manifestation of leukemia, can precede, follow, occur concurrently with, or present in the absence of (aleukemic) systemic leukemia. [escholarship.org]
Conclusions: The purpose of reporting this case is to appreciate leukemia cutis as a cutaneous manifestation of AML. Author Disclosure: A. deFonseka, none; J. Breaux, none. To cite this abstract: Breaux J, deFonseka A. [shmabstracts.com]
This skin involvement can be due to infiltration of skin by leukemic cells or it may be a part of nonspecific cutaneous manifestations. [ccij-online.org]
J Cutan Pathol. 2010;37:390-5. [ Links ] 13 Teresa S. Wright. Cutaneous manifestations of malignancy. Curr Opin Pediatr. 2011;23:407-11. [ Links ] 14 Wagner G, Fenchel K, Back W, Schulz A, Sachse MM. [scielo.br]
- Skin Disease
However, in resistant or recurrent skin disease, local therapy in the form of electron beam therapy may be used. The prognosis is poor. Although 60% of treated patients with AML achieve complete remission, only 15%–30% are disease free at 5 years. [shmabstracts.com]
Cutaneous infiltrates of myelogenous leukemia in association with pre-existing skin diseases. J Cutan Pathol 1998;25:185-6. 19. Cronin DM, George TI, Sundram UN. An updated approach to the diagnosis of myeloid leukemia cutis. [ijmpo.org]
In patients with chronic diseases, skin involvement may be associated with transformation into aggressive histology and disease progression. [emedicine.medscape.com]
Key words: Ectodermal dysplasia; Scalp; Skin diseases of large lesions, with or without deeper absence of substance, plastic surgery it is associated with vaginal aplasia. Dr. DISCUSSION. [splithatchet.com]
Workup
The traditional backbone of initial workup of AL, of acute leukemia, is composed of ctyomorphology, cytochemistry, immunophenotyping, and molecular cytogenetics. These techniques are the backbone of the initial diagnostic workup of acute leukemia. [ivoox.com]
The patient’s laboratory workup revealed the following results: hemoglobin, 5.5 g/dL (reference range, 13–18 g/dL); platelets, 128×109/L (reference range, 150–400×109/L); total white blood cell count (24.0×109/L [reference range, 4.0–11.0×109/L]), consisting [mdedge.com]
If the patient develops high unrelenting fevers, especially during the course of treatment, an infectious workup is necessary as these patients are immunocompromised and prone to infections. [ncbi.nlm.nih.gov]
Clinical Testing and Workup Laboratory tests will include a complete blood count and a peripheral blood smear. [rarediseases.org]
Treatment
That means treatments designed to remove or reduce lesions should be done in combination with systemic treatment for leukemia itself. [healthline.com]
Consequently, LC vanished after these treatments 15. [bmrat.org]
“Identifying a cohort of patients who may benefit from more intensive treatment is clinically relevant. However, having more intensive therapy may not necessarily improve treatment outcomes,” he cautioned. [cancernetwork.com]
Other treatments include electron beam therapy, localised radiation, and phototherapy. Fever usually indicates infection and requires investigation and treatment with systemic antibiotics, antifungal and antiviral treatment. The prognosis is poor. [dermnetnz.org]
Therapy-related acute myeloid leukaemia (t-AML) is a complication following exposure to cytotoxic agents used in the treatment of various primary malignancies (1). [medicaljournals.se]
Prognosis
Poor prognosis Generally a manifestation of disease progression Leukemia cutis in context of congenital myelogenous leukemia is an exception Not associated with worse prognosis Spontaneous regression of LC without treatment has been observed Prognosis [basicmedicalkey.com]
A diagnosis of leukemia cutis generally portends a poor prognosis and strongly correlates with additional sites of extramedullary involvement. [ncbi.nlm.nih.gov]
Previous reports have suggested poor prognosis for patients with LC, but these reports have largely consisted of descriptive studies with a limited number of patients. [jamanetwork.com]
Because it correlates with sites of additional extramedullary involvement, it typically portends a poor prognosis. [mdedge.com]
(Giemsa, ×40) Click here to view Discussion Leukemia cutis is the infiltration of the skin by malignant leucocytes and their precursors and signals a grave prognosis. [ccij-online.org]
Etiology
Both genetic and environmental components are involved in the etiology of any leukemia and are responsible for maturation arrest and clonal expansion of precursor cells. [ncbi.nlm.nih.gov]
Leukemia cutis commonly used to describe lymphocytic leukemias involving skin Designated by precursor B- or T-cell lineage and chronic lymphocytic leukemia “Myeloid sarcoma” is preferred term when leukemic cells are of myeloid or monocytic lineage ETIOLOGY [basicmedicalkey.com]
Depending on the lesion’s appearance, the differential diagnoses can include lymphoma, drug eruptions, infectious etiologies, sarcoidosis, metastases from other malignancies, and blistering dermatoses. [mdedge.com]
The etiology for bullae is less well understood. No association has been found with the type of leukemia cutis and butterfly rash. It only highlights one of the unusual modes of presentation. [ijdvl.com]
Bacterial, fungal, and mycobacterial cultures should also be obtained to evaluate for possible infectious etiology [9]. Our patient’s lesions were a cutaneous manifestation of his underlying plasma cell leukemia. [cureus.com]
Epidemiology
[…] involve coexpression of cutaneous lymphocyte antigen (CLA) and its interaction with specific chemokines Other factors may include CCR4, TARC, and CCL22 Predilection for sites with cutaneous inflammation (e.g., Sweet syndrome, psoriasis) CLINICAL ISSUES Epidemiology [basicmedicalkey.com]
Leukemia cutis - epidemiology, clinical presentation,and differential diagnoses. J Dtsch Dermatol Ges. 2012;10:27-36. [ Links ] 15 Lee E, Park HJ, Cho BK, Lee JY, Lee S. Leukemia cutis as early relapse of T-cell acute lymphoblastic leukemia. [scielo.br]
View Article : Google Scholar : PubMed/NCBI 4 El-Serag HB and Rudolph KL: Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology. 132:2557–2576. 2007. [spandidos-publications.com]
Leukemia cutis - epidemiology, clinical presentation, and differential diagnoses. J Dtsch Dermatol Ges. 2012 Jan; 10 (1):27-36. [ PubMed : 22115500 ] 11. Paydaş S, Zorludemir S. Leukaemia cutis and leukaemic vasculitis. Br. J. [ncbi.nlm.nih.gov]
(This is an excellent recent review of the clinical manifestations, epidemiology, and histopathology. It discusses and compares the histopathology and immunophenotypes of several types of LC. There are several clinical and histologic photographs.) [dermatologyadvisor.com]
Pathophysiology
The pathophysiology of leukemia cutis involves the migration of leukemic cells into the skin. [ncbi.nlm.nih.gov]
Pathophysiology All types of leukemia result from the abnormal development of leukocytes in the bone marrow. [emedicine.medscape.com]
In the latter, a drastic change in chemotherapy regimen will be needed. [11] LC is often associated with many other sites of extensive involvement, and generally a very poor prognosis has been noted. [12], [13], [14], [15] The pathophysiology and mechanism [ijmpo.org]
[…] molecule-1 and lymphocyte function-associated antigen-1 has been hypothesized to be involved. 113 Future studies Establishing the underlying molecular basis for the migration of leukemia cells to specific sites is critical to understanding the specific pathophysiology [bloodjournal.org]
Prevention
Antimicrobials Most patients will also receive antimicrobials as a preventative measure against infections after these skin lesions are found. [leukaemiacare.org.uk]
Salvage chemotherapy has been applied successfully to prevent the development of LC in the patient's skin. Introduction Leukemia cutis (LC) is known as a general term for skin lesions caused by leukemia 1. [bmrat.org]
[…] skin relapse. 8 It has been suggested that aggressive chemotherapy should continue even after remission to prevent further relapse. 2 The prognosis of leukemia cutis tends to be grave, with 88% of patients dying within one year of diagnosis. 1,3,5 Another [the-dermatologist.com]
[…] therapy using radiation: electron beam, surgery, or light therapy to remove or reduce skin lesions Topical treatments: steroid creams, lidocaine, or other medications to relieve the pain and other symptoms Antimicrobial medications: medications to help prevent [healthline.com]
Therefore, new research directions are crucial to predict, prevent and combat virus diseases. This Special Issue will include manuscripts on different aspects of virus diseases in both humans and animals. [mdpi.com]