Scleromyxedema in a 21 year old female patient with acute lymphoblastic leukemia: a case report

Abstract

Background Scleromyxedema is a rare, para-neoplastic, chronic, progressive condition of the Lichen myxedematosus (LM) family. The clinical picture consists of generalized confluent papular eruptions with possible systemic manifestations, which may be fatal as it still constitutes a therapeutic dilemma. Histologically, it is characterized by dermal mucin deposition, fibroblast proliferation with fibrosis, with monoclonal gammopathy in the absence of thyroid disease. Some atypical forms of the disease were reported in the literature, but none were reported in acute leukemia. Case presentation Herein, we report a case of a 21 years old female patient, known case of acute lymphoblastic leukemia (ALL), who developed numerous hyper-pigmented erythematous papules and plaques, mainly over her thighs, lower abdomen, and sub-mammary flexures. Histopathology of skin lesions confirmed the diagnosis of atypical scleromyxedema. Her symptoms significantly improved with the use of high dose intravenous immunoglobulin (IVIG). Conclusions Despite that scleromyxedema is associated with many hematologic disorders, it is very rarely associated with acute lymphoblastic leukemia, and a high index of suspicion is needed for diagnosis. IVIG remains a reasonable management of such a disabling disease.

Lichen myxedematosus associated with pulmonary mucosa‐associated lymphoid tissue lymphoma

“…The etiology has not been elucidated, but overstimulation of fibroblasts by certain cytokines, such as interleukin-1, tumor necrosis factorα, and transforming growth factorβ, could play a role in the pathogenesis. 1 LM is often associated with monoclonal gammopathy. 2 However, the association between malignancies and LM has rarely been described.…”

Case of new-onset scleromyxoedema–scleroedema spectrum disorder in a patient with CLL

“…1 While scleromyxoedema has been described in patients with neoplasms, none has been described in patients with chronic lymphocytic leukaemia (CLL). [2][3][4][5] Here, we present a patient whose new-onset scleromyxoedema likely coincided with his CLL relapse.…”