Leukaemia cutis (LC) describes infiltration of the skin by leukaemia cells, resulting in clinically identifiable cutaneous lesions. LC has a wide range of clinical manifestations, which can make it difficult to distinguish LC from other skin changes. In a group of patients, LC can be the first manifestation of leukaemia, therefore skin biopsy is crucial for the diagnosis. In this mini review, we discuss various types of leukaemia most frequently represented in leukaemia cutis, in both children and adults and skin changes in multiple myeloma, focusing on the clinical presentation of LC and prognosis in patients.
Introduction: Trichoscopy greatly facilitates clinical diagnosis in patients with hair loss and may decrease the necessity for histopathological examination. Structures which may be revealed by trichoscopy include hair shafts, hair follicle openings, the perifollicular epidermis, and cutaneous microvessels. Cutaneous microvessels revealed in trichoscopy may vary in type and number depending on the scalp area, type of the disease, and its activity. Firm direct pressure (diascopy) might result in their blanching, but as of yet, there are no studies on the types of vessels that do or do not blanch on applying pressure. Methods: We studied interfollicular twisted loops in 16 cases of biopsy-confirmed scalp psoriasis and 37 cases of arborizing vessels in normal subjects and seborrheic dermatitis patients. Results: We observed that all arborizing red line vessels blanched on applying pressure. Instead, the vast majority of twisted and simple loops, despite their vascular nature, did not blanch on performing diascopy. Conclusion: In the light of these findings, diascopy of vascular changes in hair loss patients might provide additional clues for a proper diagnosis, especially in differentiating scalp psoriasis, seborrheic dermatitis, and discoid lupus erythematosus.
Skin infiltration by leukaemia (leukaemia cutis-LC) in chronic lymphocytic leukaemia (CLL) occurs in less than 5% of affected patients. It is significantly less common than skin cancers complicating the course of CLL, with an incidence of up to 20%, and non-specific skin lesions. Therefore, it is crucial to perform additional diagnostic tests to establish the aetiology of skin lesions in CLL patients. In this report, we present a case of a 60-year-old woman with CLL, in whom diffuse skin lesions were observed seven years after diagnosis, histologically confirmed as CLL infiltrates, and who responded well to treatment with ibrutinib.
Primary cicatricial alopecia (PCA) encompasses a diverse group of inflammatory diseases characterized by the irreversible replacement of hair follicle structures by fibrous tissue. Although the pathogenesis of PCA remains not fully understood, the key to its understanding might be the location of dendritic cells (DCs) inflammatory infiltrate. One of the systemic therapy of choice in PCA patients is hydroxychloroquine (HCQ). We hypothesized that DCs are implicated in PCA pathogenesis and that they might constitute the biological target of HCQ treatment. For these reasons, we investigated whether DCs could affect the antimalarial responsiveness, and if DCs might be used as predictive factor of responsiveness to HCQ. In this retrospective cohort study, 65 patients diagnosed with PCA were grouped accordingly to their response to HCQ therapy. Skin biopsies had been taken before the treatment was started. Cell count was performed on immunohistochemistry by using characteristic monoclonal antibodies to specific subpopulations of DCs. In almost every second
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