Leukemia cutis in a patient with chronic neutrophilic leukemia

Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative disorder. Less than 50 cases have been reported. We report the first case of CNL with an associated leukemia cutis. CNL was diagnosed in a 74-year-old white woman in 1998, based on neutrophilic infiltration of the bone marrow and absen...

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Bibliographic Details
Published in:	Journal of the American Academy of Dermatology Vol. 44; no. 2; pp. 365 - 369
Main Authors:	Willard, Robert J., Turiansky, George W., Genest, Glenn P., Davis, Brad J., Diehl, Louis F.
Format:	Journal Article
Language:	English
Published:	New York, NY Mosby, Inc 01-02-2001 Elsevier
Subjects:	Aged Antineoplastic Combined Chemotherapy Protocols - administration & dosage Biological and medical sciences Biopsy, Needle Bone Marrow Cells - pathology Dermatology Disease Progression Fatal Outcome Female Hand Dermatoses - diagnosis Humans Leg Dermatoses - diagnosis Leukemia - diagnosis Leukemia - drug therapy Leukemia - pathology Leukemia, Myelogenous, Chronic, BCR-ABL Positive - diagnosis Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy Leukemia, Myelogenous, Chronic, BCR-ABL Positive - pathology Medical sciences Skin - pathology Tumors of the skin and soft tissue. Premalignant lesions Case study Human Myeloproliferative syndrome Skin disease Chronic Cutaneous hematologic disease Association Leukemia Granulocyte Malignant hemopathy Skin Neutrophil
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Summary:	Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative disorder. Less than 50 cases have been reported. We report the first case of CNL with an associated leukemia cutis. CNL was diagnosed in a 74-year-old white woman in 1998, based on neutrophilic infiltration of the bone marrow and absence of the Philadelphia chromosome. The patient presented to the dermatology service in August 1998 with a 2-week history of a pruritic eruption on the arms, hands, and legs. Physical examination revealed red to violaceous plaques on both thighs and knees, in addition to purpuric patches and plaques on the dorsal hands, arms, and legs. Leukemia cutis was demonstrated on biopsy specimens of several lesional sites. The eruption progressed, despite treatment with topical and systemic corticosteroids. Treatment with systemic chemotherapy did affect partial resolution of the eruption, with parallel decreases in bone pain and white blood cell count, but the disease progressed and the patient ultimately died 5 months after her initial skin findings. Only one other case of CNL with dermatologic manifestations has been reported, CNL associated with a reactional neutrophilic dermatosis. Comparison to and differentiation from this case is discussed. The importance of distinguishing the specific infiltrates of leukemia from the nonspecific infiltrates of reactional dermatoses, such as Sweet's syndrome, is illustrated. (J Am Acad Dermatol 2001;44:365-9.)
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	0190-9622 1097-6787
DOI:	10.1067/mjd.2001.103996