Cutaneous manifestations of hematologic malignancies the experience of an Italian dermatology department

Abstract

In recent years, dermatologic manifestations in oncohematologic patients have become more common. The aim of our study was to determine the incidence and heterogeneity of skin manifestations in patients followed at our Hematology Department. This observational monocentrical study was conducted on 60 patients. We divided the observed conditions in exanthematous, purpuric, vesicular‐bullous, papulonodular, urticarial, and eczematous manifestations. Moreover, all lesions were classified according to pathogenesis, in (a) specific skin manifestations, caused by neoplastic skin infiltration; (b) immune‐mediated manifestations, based on immunological mechanisms; and (c) skin lesions due to immunodeficiency. Altogether, 73 clinical manifestations were reported. Specific manifestations (a) were detected in 15.1% of the cases, mainly with papulonodular appearance. Immune‐mediated manifestations (b) were found in 37 cases (50.7%), particularly with eczematous or exanthematous appearance, and leukemia was the malignancy most frequently reported in these patients. Eventually, lesions due to immunosuppression (c) were reported in 34.2% of the cases. They were represented by infections and cutaneous malignancies, and usually manifested with papulonodular lesions. Skin lesions in oncohematologic patients are a common event. A multidisciplinary approach based on the collaboration between the hematologist and the dermatologist is crucial to achieve a proper diagnosis, and correctly manage these manifestations.

Retrospective data from a dedicated outpatient dermatology clinic for hemato‐oncology patients

“…2). We have also observed a significant incidence of inflammatory dermatoses, mostly common conditions like eczema, rosacea, and psoriasis 2,3 . Another important aspect is the incidence of EDHM 4 .…”

“…We believe this condition is underdiagnosed and refractory to available treatments, making its management an unmet clinical need. We are aware that this study may not represent the real incidence of these conditions; in particular, our hospital is a macroregional referral center for myeloproliferative disorders and for cutaneous lymphomas, which led to an increase in their incidence as compared to previous studies investigating the same scenario 2,3 . Another limitation of the study is its retrospective nature and the lack of information on patients’ skin phototypes and type of sun exposure, which are known to influence the incidence of NMSC.…”

Specific cutaneous infiltrates in patients with haematological neoplasms: a retrospective study with 49 patients

“…5,8 In our study, systemic lymphoma represented the most common cause of specific cutaneous infiltration (44.9%), in accordance with other studies. 2,9 Regarding clinical features, most patients presented with multiple skin lesions (≥3). Nodules were the predominant Cases with cutaneous infiltration before systemic diagnosis.…”

Immune-Mediated Cutaneous Paraneoplastic Syndromes Associated With Hematologic Malignancies: Skin as a Mirror of Hematologic Neoplasms

“…A paraneoplastic syndrome consists of a process when an underlying neoplasm has a causal relationship with a group of clinical manifestations - aside from the tumor and its metastases [ 2 ]. Due to multiple organs being involved and an extensive variety of neoplasms associated (both solid and hematologic), a wide range of these syndromes have been described [ 3 ].…”

“…In the past few years, cutaneous manifestations have become more frequent in HMs and up to 25% are due to paraneoplastic cutaneous syndromes, and of these, up to half are immune-mediated. In a descriptive study, the most common HM with cutaneous manifestations was leukemia (38.3%), followed by non-Hodgkin's lymphoma (26.7%) and multiple myeloma (21.7%) [ 3 ].…”