Introduction
Leukemia cutis
Authors | Age/gender | HCL status at skin lesion diagnosis | Clinical characteristic of skin lesions | Histology of skin lesions | Treatment of HCL and leukemia cutis |
---|---|---|---|---|---|
Lawrence et al. [31] | 59/M | HCL in the skin, blood, and BM diagnosed at presentation | Multiple erythematous, slightly raised papules, and pustular lesions over all of the extremities, palms, and trunk | Throughout the dermis, large numbers of uniform, mononuclear cells were arranged in discrete patches, usually surrounding dermal blood vessels. Electron microscopy performed on the BM and skin biopsy specimens revealed cells consistent with a diagnosis of HCL | Skin lesions gradually disappeared over 1 to 2 weeks after splenectomy |
Finan et al. [33] | 74/M | HCL diagnosed 2 years before development of leukemia cutis | Bilateral violaceous infiltrative plaques over the temporal portion of the scalp and violaceous nodules and infiltrative plaques on the central part of the chest | Histology from punch biopsy specimens confirmed the diagnosis of leukemia cutis | Treatment with chlorambucil and prednisone ineffective; the patient died from infection |
Arai et al. [29] | 68/M | HCL in the skin, blood, and BM at presentation | Crops of 0.2–0.5-cm erythematous papules over the upper extremities | Light microscopy: tumor cells judged to be hairy cells spared the epidermis but infiltrated the upper dermis as patchy clusters around small blood vessels and skin; 80% of infiltrating hairy cells in the upper dermis showed diffuse cytoplasmic positivity by TRAP staining | IFN-α 3 million units per day for 16 weeks, when skin lesions had improved; retreated with IFN-α 6 million units per day—CR of skin lesions after 6 weeks |
Bilsland et al. [30] | 62/M | HCL in the skin, blood, and BM at presentation | Transient, widespread, non-pruritic skin eruption, with areas of erythema, purpura, and indurated plaques | Skin biopsy: infiltration of the papillary dermis by large mononuclear B cells surrounded by smaller lymphoid T cells | Eruption gradually disappeared 17 days after it first developed. Improvement after splenectomy and remission 45 months after presentation on IFN-α maintenance |
Colovic et al. [26] | 60/M | HCL in the skin and BM at presentation | Painless maculopapular, red brick skin infiltrates 1–2 cm in diameter of the almost whole skin | Perivascular and patchy infiltrates, composed of DBA44 positive small- to medium-sized lymphoid cells, with oval or indented nuclei, with homogenous, ground-glass chromatin, inconspicuous nucleoli, and abundant, pale blue cytoplasm | Cladribine (2 courses) and splenectomy, cutaneous lesion disappeared after HCL treatment |
Ergene et al. [35] | 59/M | HCL in the skin and BM at presentation | Pale skin tumor infiltrated the musculus pectoralis major with a diameter of 11 × 30 cm, with multiple scars attributed to sharp blade scars other than the main mass | Lymphoid cells with round nucleus and cytoplasm ridges in BM biopsy and epidermis-dermis, respectively. Flow cytometry—CD11c: 73.28%, CD19: 70.07%, CD22: 68.08% | Cladribine (1 course), complete response in BM, cutaneous infiltration completely disappeared, lasting remission at 5 years |
Fino et al. [36] | 47/M | HCL in the skin and BM at presentation | Purplish-brown skin nodule on the back of the left hand, 2 × 2 cm, with an erythematous halo, ulcerated surface, and squamous crusts | Histology: infiltration of dermal tissues by leukemoid cells positive for HCL surface markers and degenerative changes of the epidermis, dermoepidermal border, and collagen | Skin lesion was surgically removed |