title: Leukemia cutis in acute lymphocytic leukemia masquerading as viral exanthem.
abstract: Leukemia cutis is a specific skin lesion caused by infiltration of leukemic cells into the skin. It is uncommon in acute lymphocytic leukemia (ALL). It typically manifests as red or violaceous papules, nodules, or plaques, mainly on the face. Leukemia cutis presenting with a generalized viral exanthem-like maculopapular eruption appears to be rare in the English literature. We report such a case. A 19 year-old man presented with a generalized purpuric maculopapular eruption of eight day's duration. Hematologic studies showed changes of acute lymphocytic leukemia, T-cell type. A skin biopsy specimen revealed a cuff-like, dense, perivascular infiltration of atypical lymphocytes in the upper and mid-dermis, consistent with leukemia cutis. The rash resolved in two weeks after chemotherapy. Our case illustrates that leukemia cutis should be considered in the differential diagnosis of a generalized morbilliform viral exanthem-like eruptions. Skin biopsy is important in establishing the diagnosis.
authors.affiliation: Department of Dermatology, National Cheng-Kung University Hospital, Taiwan, ROC.
authors.forename: S C
authors.initials: SC
authors.lastname: Chao
authors.forename: J Y
authors.initials: JY
authors.lastname: Lee
authors.forename: C J
authors.initials: CJ
authors.lastname: Tsao
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D006801:Humans; D017254:Leukemic Infiltration / Q000473:pathology*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D012867:Skin / Q000473:pathology*; D017193:Skin Diseases, Viral / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D016896:Treatment Outcome