title: Skin infiltration in acute promyelocytic leukemia.
abstract: Acute promyelocytic leukemia (APL) is a type of acute leukemia showing unique clinical, morphological and cytogenetic features. A skin infiltration by APL cells is an extremely rare occasion, but there have been several case reports of leukemia cutis in APL, in which all-trans retinoic acid (ATRA) may have induced the skin infiltration. However, no immunohistochemical analyses of the APL cells in the skin have been done to date. A 30-year-old woman with APL developed multiple reddish purple nodules on the extremities in her second complete remission. Histological findings revealed a dense infiltration of medium to large atypical cells, which were positive for myeloperoxidase, throughout the dermis. Despite the conventional chemotherapy and ATRA therapy she died from disseminated intravascular coagulation during her third relapse. Leukemic cells in the peripheral blood before the treatment with ATRA revealed CD3-/CD4-/CD5-/CD7-/CD8-/CD10-/CD13++/CD14-/CD19 -/ CD20-/CD33++/CD38++/CD41-/Ia-, but they expressed CD3-/CD4-/CD5-/CD7++/ CD8-/CD10-/CD13++/CD14-/CD19-/CD20-/CD33++ /CD38++/CD41+/Ia+ after the treatment. We suggest that the alternation of the surface molecules on the tumor cells is closely associated with the skin infiltration of APL cells.
authors.affiliation: Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nagao
authors.forename: A
authors.initials: A
authors.lastname: Kikuchi
authors.forename: Y
authors.initials: Y
authors.lastname: Kawai
authors.forename: M
authors.initials: M
authors.lastname: Kizaki
authors.forename: Y
authors.initials: Y
authors.lastname: Ikeda
authors.forename: T
authors.initials: T
authors.lastname: Nishikawa
mesh_terms: D036541:ADP-ribosyl Cyclase; D051997:ADP-ribosyl Cyclase 1; D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D018941:Antigens, CD19 / Q000032:analysis; D018951:Antigens, CD20 / Q000032:analysis; D019011:Antigens, CD7 / Q000032:analysis; D000943:Antigens, Differentiation / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018826:CD13 Antigens / Q000032:analysis; D017252:CD3 Complex / Q000032:analysis; D015704:CD4 Antigens / Q000032:analysis; D018956:CD5 Antigens / Q000032:analysis; D016827:CD8 Antigens / Q000032:analysis; D002423:Cause of Death; D015815:Cell Adhesion Molecules / Q000032:analysis; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D000949:Histocompatibility Antigens Class II / Q000032:analysis; D006801:Humans; D007641:Keratolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy / Q000473:pathology*; D017254:Leukemic Infiltration / Q000188:drug therapy / Q000473:pathology; D018950:Lipopolysaccharide Receptors / Q000032:analysis; D008562:Membrane Glycoproteins / Q000032:analysis; D009699:N-Glycosyl Hydrolases / Q000032:analysis; D015260:Neprilysin / Q000032:analysis; D009195:Peroxidase / Q000032:analysis; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000032:analysis; D063268:Sialic Acid Binding Ig-like Lectin 3; D012867:Skin / Q000187:drug effects / Q000473:pathology*; D014212:Tretinoin / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D015703:Antigens, CD; D018941:Antigens, CD19; D018951:Antigens, CD20; D019011:Antigens, CD7; D000943:Antigens, Differentiation; D015214:Antigens, Differentiation, Myelomonocytic; D000970:Antineoplastic Agents; D017252:CD3 Complex; C571163:CD33 protein, human; D015704:CD4 Antigens; D018956:CD5 Antigens; D016827:CD8 Antigens; D015815:Cell Adhesion Molecules; D000949:Histocompatibility Antigens Class II; D007641:Keratolytic Agents; D018950:Lipopolysaccharide Receptors; D008562:Membrane Glycoproteins; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D063268:Sialic Acid Binding Ig-like Lectin 3; D014212:Tretinoin; D009195:Peroxidase; D009699:N-Glycosyl Hydrolases; D036541:ADP-ribosyl Cyclase; C498154:CD38 protein, human; D051997:ADP-ribosyl Cyclase 1; D018826:CD13 Antigens; D015260:Neprilysin