Leukemia Cutis in Acute Myelomonocytic Leukemia: Infiltration to Minor Traumas and Scars

Abstract

We describe a patient with acute myelomonocytic leukemia who demonstrated leukemic cell infiltration to scratched wounds and scars from trauma. A 65-year-old Japanese woman developed low grade fever, headache and exanthema. Hematology testing disclosed leukocytosis of 95,600/mm3 with 65% monocytes and 9% blast cells. Infiltrated erythema and nodules were disseminated over most of her body. Moreover, linear scratched wounds and traumatic scars were indurated. Skin biopsy showed dense atypical mononuclear cell infiltration with monocytic characteristics. We discuss the possible reasons for the infiltration of leukemia cells into the wounds and scars from trauma.

Leukemia cutis – epidemiology, clinical presentation, and differential diagnoses

“…On the face, the transition from erythema to nodular or plaque-like infiltration can lead to a grotesque appearance known as leonine facies [5,8]. Another clinical feature of LC is the development of nodules and infiltration of scars [29,32,39,53,54]. If the erythema spreads, erythroderma may occur, accompanied by marked sebostasis and pityriasiform or exfoliative scaling [5,8,55].…”

Unusual Tumor Formation in the Tongue of an Acute Myelocytic Leukemia Patient: Report of a case.

“…These lesions may occur anywhere in the skin. Since leukemia cutis may arise in scars from recent surgery, burns, herpes zoster, and herpes simplex, skin injury and inflammation may play significant roles in leukemic cell infiltration as local cutaneous factors (16). Keratinocytes produce a wide variety of immune and inflammatory cytokines.…”

Acute Myelomonocytic Leukemia with Skin Localizations

“…Leukemia cutis is an important element in the differen tial diagnosis of the 'blueberry muffin baby' picture described above (table 2) [2][3][4][5][6][7]. The lymphoidal and the nonlymphoidal form of leukemia cutis are distinguished.…”