Leukaemia Cutis: Clinical Features and Outcomes of 56 Patients
DOI:
https://doi.org/10.2340/actadv.v102.1123Keywords:
leukemia cutis, prognosis, leukemia, acute myelogenous leukemia, acute lymphoblastic leukemiaAbstract
Leukaemia is a malignant neoplasm of the haematopoietic system. Cutaneous manifestations of leukaemia are called leukaemia cutis, and are regarded as a sign of poorer prognosis and shorter survival time. A single-institution retrospective review was performed of medical records of patients diagnosed with leukaemia cutis in the dermatology department of Seoul St Mary’s Hospital between January 2012 and April 2021. Fifty-six cases with cutaneous leukaemic involvement and underlying haematological malignancy were included (40 acute myelogenous leukaemia, 8 acute lymphoblastic leukaemia, 3 chronic myeloid leukaemia, 2 chronic lymphocytic leukaemia, and 3 myelodysplastic syndrome). Male-female ratio 1.9:1, mean age at diagnosis 45.8 years. Plaques (28%) and papules (27%) were the most common skin lesions, followed by patches (18%) and nodules (16%). Mean time from diagnosis of leukaemia to development of leukaemia cutis was 12.3 months. Forty-six patients (84%) died during the 7-year follow-up; mean time from diagnosis of leukaemia cutis to death was 5.4 months. The results suggest that leukaemia cutis is associated with poor outcomes in patients with leukaemia. Comprehensive skin examination of these patients may help diagnose leukaemia cutis early, enabling prompt treatment.
Downloads
References
Weedon D. Weedon's skin pathology e-book: expert consult-online and print. Milton, ON, Canada: Elsevier Health Sciences; 2009.
Wang S-M, Park S-S, Park S-H, Kim N-Y, Kang DW, Na H-R, et al. Pre-transplant depression decreased overall survival of patients receiving allogeneic hematopoietic stem cell transplantation: a nationwide cohort study. Sci Rep 2020; 10: 1-10.
https://doi.org/10.1038/s41598-020-71208-2 DOI: https://doi.org/10.1038/s41598-020-71208-2
Wagner G, Fenchel K, Back W, Schulz A, Sachse MM. Leukemia cutis - epidemiology, clinical presentation, and differential diagnoses. J Dtsch Dermatol Ges 2012; 10: 27-36.
https://doi.org/10.1111/j.1610-0387.2011.07842.x DOI: https://doi.org/10.1111/j.1610-0387.2011.07842.x
Angulo J, Haro R, Gonzalez-Guerra E, Farina MC, Martin L, Requena L. Leukemia cutis presenting as localized cutaneous hyperpigmentation. J Cutan Pathol 2008; 35: 662-665.
https://doi.org/10.1111/j.1600-0560.2007.00888.x DOI: https://doi.org/10.1111/j.1600-0560.2007.00888.x
Paydas S, Zorludemir S. Leukaemia cutis and leukaemic vasculitis. Br J Dermatol 2000; 143: 773-779.
https://doi.org/10.1046/j.1365-2133.2000.03774.x DOI: https://doi.org/10.1046/j.1365-2133.2000.03774.x
Su WP. Clinical, histopathologic, and immunohistochemical correlations in leukemia cutis. Semin Dermatol 1994; 13: 223-230.
Grunwald MR, McDonnell MH, Induru R, Gerber JM. Cutaneous manifestations in leukemia patients. Semin Oncol 2016; 43: 359-365.
https://doi.org/10.1053/j.seminoncol.2016.02.020 DOI: https://doi.org/10.1053/j.seminoncol.2016.02.020
Su WD, Buechner S, Li C-Y. Clinicopathologic correlations in leukemia cutis. J Am Acad Dermatol 1984; 11: 121-128.
https://doi.org/10.1016/S0190-9622(84)70145-9 DOI: https://doi.org/10.1016/S0190-9622(84)70145-9
Wang CX, Pusic I, Anadkat MJ. Association of leukemia cutis with survival in acute myeloid leukemia. JAMA Dermatol 2019; 155: 826-832.
https://doi.org/10.1001/jamadermatol.2019.0052 DOI: https://doi.org/10.1001/jamadermatol.2019.0052
Vasconcelos ERA, Bauk AR, Rochael MC. Cutaneous myeloid sarcoma associated with chronic myeloid leukemia. An Bras Dermatol 2017; 92: 50-52.
https://doi.org/10.1590/abd1806-4841.20176042 DOI: https://doi.org/10.1590/abd1806-4841.20176042
Kang YS, Kim HS, Park HJ, Lee JY, Kim HO, Cho BK, et al. Clinical characteristics of 75 patients with leukemia cutis. J Korean Med Sci 2013; 28: 614-619.
https://doi.org/10.3346/jkms.2013.28.4.614 DOI: https://doi.org/10.3346/jkms.2013.28.4.614
Li L, Wang Y, Lian CG, Hu N, Jin H, Liu Y. Clinical and pathological features of myeloid leukemia cutis. An Bras Dermatol 2018; 93: 216-221.
https://doi.org/10.1590/abd1806-4841.20186327 DOI: https://doi.org/10.1590/abd1806-4841.20186327
Watson KM, Mufti G, Salisbury JR, du Vivier AW, Creamer D. Spectrum of clinical presentation, treatment and prognosis in a series of eight patients with leukaemia cutis. Clin Exp Dermatol 2006; 31: 218-221.
https://doi.org/10.1111/j.1365-2230.2005.02022.x DOI: https://doi.org/10.1111/j.1365-2230.2005.02022.x
Haidari W, Strowd LC. Clinical characterization of leukemia cutis presentation. Cutis 2019; 104: 326-330;E3.
Howlader N, Noone AM, Krapcho M, Miller D, Brest A, Yu M, et al. SEER Cancer Statistics Review, 1975-2018, National Cancer Institute. Bethesda, MD.
Park HJ, Park EH, Jung KW, Kong HJ, Won YJ, Lee JY, et al. Statistics of hematologic malignancies in Korea: incidence, prevalence and survival rates from 1999 to 2008. Korean J Hematol 2012; 47: 28-38.
https://doi.org/10.5045/kjh.2012.47.1.28 DOI: https://doi.org/10.5045/kjh.2012.47.1.28
Park EH, Lee HW, Won YJ, Ju HY, Oh C-M, Ingabire C, et al. OCe. Nationwide statistical analysis of myeloid malignancies in Korea: incidence and survival rate from 1999 to 2012. Blood Res 2015; 50: 204-217.
https://doi.org/10.5045/br.2015.50.4.204 DOI: https://doi.org/10.5045/br.2015.50.4.204
Kaddu S, Zenahlik P, Beham-Schmid C, Kerl H, Cerroni L. Specific cutaneous infiltrates in patients with myelogenous leukemia: a clinicopathologic study of 26 patients with assessment of diagnostic criteria. J Am Acad Dermatol 1999; 40: 966-978.
https://doi.org/10.1016/S0190-9622(99)70086-1 DOI: https://doi.org/10.1016/S0190-9622(99)70086-1
Krooks JA, Weatherall AG. Leukemia cutis in acute myeloid leukemia signifies a poor prognosis. Cutis 2018; 102: 266;271;272.
Osio A, Battistella M, Feugeas JP, Cuccuini W, Noguera ME, Petrella T, et al. Myelodysplasia cutis versus leukemia cutis. J Invest Dermatol 2015; 135: 2321-2324.
https://doi.org/10.1038/jid.2015.146 DOI: https://doi.org/10.1038/jid.2015.146
Reap L, Goldman L. Focal blast crisis in concomitant myelodysplastic syndrome and chronic myelogenous leukemia. Leuk Res Rep 2020; 14: 100225.
https://doi.org/10.1016/j.lrr.2020.100225 DOI: https://doi.org/10.1016/j.lrr.2020.100225
Takeuchi S, Akasaka E, Rokunohe D, Kayo SJ, Matsuzaki Y, Ooshima H, et al. Leukemia cutis is an early sign of blast transformation that may mimic a common skin disease: sycosis-like eruptions in chronic myelomonocytic leukemia. J Dermatol 2010; 37: 916-918.
https://doi.org/10.1111/j.1346-8138.2010.00901.x DOI: https://doi.org/10.1111/j.1346-8138.2010.00901.x
Findakly D, Amar S. A rare case of leukemia cutis as the first presentation of a myelodysplastic syndrome to acute myeloid leukemia transformation. Cureus 2020; 12: e8698.
https://doi.org/10.7759/cureus.8698 DOI: https://doi.org/10.7759/cureus.8698
Thomas RM, Harrell JE, Rudnick E, Auerbach J, DeBenedetto A, Torres A, et al. Leukemia cutis mimicking tumid lupus as the presenting sign in a case of mixed T/B-cell acute lymphoblastic leukemia. JAAD Case Rep 2020; 6: 598-602.
https://doi.org/10.1016/j.jdcr.2020.04.033 DOI: https://doi.org/10.1016/j.jdcr.2020.04.033
Miller MK, Strauchen JA, Nichols KT, Phelps RG. Concurrent chronic lymphocytic leukemia cutis and acute myelogenous leukemia cutis in a patient with untreated CLL. Am J Dermatopathol 2001; 23: 334-340.
https://doi.org/10.1097/00000372-200108000-00011 DOI: https://doi.org/10.1097/00000372-200108000-00011
Mittal A, Gogia A, Mallick S, Gupta R. Leukemia cutis: a rare initial presentation of chronic lymphocytic leukemia. Indian J Hematol Blood Transfus 2019; 35: 367-368.
https://doi.org/10.1007/s12288-018-1057-3 DOI: https://doi.org/10.1007/s12288-018-1057-3
Andriescu EC, Coughlin CC, Cheng CE, Prajapati VH, Huang JT, Schmidt BA, et al. Pediatric leukemia cutis: a case series. Pediatr Dermatol 2019; 36: 658-663.
https://doi.org/10.1111/pde.13864 DOI: https://doi.org/10.1111/pde.13864
Kang YS, Lee JH, Park YM, Lee JY. Eleven-year-old girl with multiple nodules on the trunk. Pediatr Dermatol 2015; 32: 415-416.
https://doi.org/10.1111/pde.12397 DOI: https://doi.org/10.1111/pde.12397
Chang YW, Lee CH, Tseng HC. Leukemia cutis in a medical center in southern Taiwan: a retrospective study of 42 patients. J Formos Med Assoc 2021; 120: 226-233.
https://doi.org/10.1016/j.jfma.2020.04.025 DOI: https://doi.org/10.1016/j.jfma.2020.04.025
Vishalakshi V, Torsekar RG, Shinde S. Aleukemic leukemia cutis. Indian J Dermatol Venereol Leprol 2007; 73: 109-111.
https://doi.org/10.4103/0378-6323.31897 DOI: https://doi.org/10.4103/0378-6323.31897
Published
How to Cite
License
Copyright (c) 2022 Hwa Jung Yook, Joon Ho Son, Yeong Ho Kim, Ju Hee Han, Ji Hyun Lee, Young Min Park, Nack-Gyun Chung, Hee Je Kim, Chul Hwan Bang
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.
Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.
