A case of monocytic leukaemia cutis in a patient with myelodysplastic syndrome transforming to acute myeloid leukaemia.
A 49-year-old woman presented with a 1-year-history of a widespread eruption which proved to be due to leukaemia cutis. Subsequently, she developed pancytopaenia and a bone marrow biopsy revealed refractory anaemia with excess blasts in transformation (RAEB-T) with a high monoblastic component. This transformed into acute myeloid leukaemia. Leukaemia cutis in this context is well described but in this patient it became manifest 1 year prior to referral to the dermatologist. When occurring with a myelodysplastic syndrome, leukaemia cutis often heralds malignant transformation to acute myeloid leukaemia. Prompt diagnosis in this situation may identify a group of high-risk patients with myelodysplastic syndrome for whom chemotherapy and allogenic bone marrow transplantation, rather than the more conventional approach of supportive treatment, could be a more appropriate management strategy.
Perez
A
A
Bristol Dermatology Centre, Bristol Royal Infirmary, UK. alfonsoperezdeve@aol.com
Kennedy
C
C
Standen
G
G
Oxley
J
J
D000754:Anemia, Refractory, with Excess of Blasts / Q000473:pathology* / Q000628:therapy; D016026:Bone Marrow Transplantation / Q000379:methods; D002471:Cell Transformation, Neoplastic; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007938:Leukemia / Q000473:pathology* / Q000628:therapy; D015470:Leukemia, Myeloid, Acute / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D008875:Middle Aged