title: Specific skin manifestations in acute leukemia with monocytic differentiation. A morphologic and immunohistochemical study of 11 cases.
abstract: BACKGROUND
  Monocytic differentiation is present in the myelomonocytic (M4) and monocytic (M5) type of acute myeloblastic leukemia. Infiltration of the skin in acute myelomonocytic leukemia occurs in 10-20% of patients, the skin lesions occasionally being the first symptom, even preceding monocytosis.
  
  
  METHODS
  Eleven patients with myelomonocytic (n = 2) and monocytic leukemia (n = 9) were studied who had skin manifestations.
  
  
  CONCLUSIONS
  Clinically, all patients showed disseminated papules or nodules that corresponded histologically to nodular or diffuse infiltrates of monocytoid cells, occasionally displaying a whorled pattern. The currently available antibodies for paraffin-embedded sections (lysozyme, elastase, leukocyte common antigen (CD45), MT1 (CD43), Leu-M1 (CD15), LN2 (CD74), MB2, MB1 (CD45RA), LN1 (w75), Mac387, L26 (CD20), UCHL1 (CDR0), MT2 (CD45RA), and KP-1 (CD68)) and chloracetate-esterase are not more helpful in diagnosis than are the histologic findings. By contrast, the antibodies used on frozen sections (Leu-4 (CD3), Leu-3a (CD4), BA1 (CD24), B4 (CD19), Leu-M5 (CD11c), Vim12 (CD11b), VimD5 (CD15), KiM6 (CD68), KIM7 (CD68), My7 (CD13), and My9 (CD33) allow the definition of a reaction pattern that is diagnostic for acute myeloid leukemia with monocytic differentiation.
authors.affiliation: Department of Dermatology, University of Innsbruck, Austria.
authors.forename: N
authors.initials: N
authors.lastname: Sepp
authors.forename: T
authors.initials: T
authors.lastname: Radaszkiewicz
authors.forename: C J
authors.initials: CJ
authors.lastname: Meijer
authors.forename: J
authors.initials: J
authors.lastname: Smolle
authors.forename: H
authors.initials: H
authors.lastname: Seewann
authors.forename: P
authors.initials: P
authors.lastname: Fritsch
authors.forename: H
authors.initials: H
authors.lastname: Kerl
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D001706:Biopsy; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007124:Immunoenzyme Techniques; D015479:Leukemia, Myelomonocytic, Acute / Q000473:pathology*; D017254:Leukemic Infiltration; D008297:Male; D008875:Middle Aged; D016612:Paraffin Embedding; D012867:Skin / Q000473:pathology*
chemical_list: D000911:Antibodies, Monoclonal