'Specific' cutaneous infiltrate of B-cell chronic lymphocytic leukemia at the site of a florid herpes simplex infection.
BACKGROUND
Specific cutaneous infiltrates in patients with leukemia generally carry a grim prognosis. However, non-neoplastic skin diseases may be associated with recruitment of normal and neoplastic leukocytes circulating in the peripheral blood. In those instances, neoplastic cells may be detected in skin lesions without an adverse effect on prognosis.


METHODS
In a patient with B-cell chronic lymphocytic leukemia, a specific infiltrate developed at the site of a florid herpes simplex infection. Clinically, the lesion presented itself as an ulcerated tumor.


RESULTS
Histopathologically, the lesion was characterized by a dense, diffuse infiltrate of small hyperchromatic lymphocytes throughout the entire dermis. Lymphocytes showed an aberrant CD20(+)/CD43(+)/CD5(+) phenotype of neoplastic B cells, and monoclonal rearrangement of immunoglobulin gamma genes could be demonstrated by polymerase chain reaction. Although criteria for leukemia cutis were fulfilled, the patient did well.


CONCLUSIONS
The cutaneous infiltrate of neoplastic cells seemed to be part of a physiologic response to the antigenic stimulus, rather than indicating an exacerbation of leukemia. Ziemer M, Bornkessel A, Hahnfeld S, Weyers W. 'Specific' cutaneous infiltrate of B-cell chronic lymphocytic leukemia at the site of a florid herpes simplex infection.
Ziemer
Mirjana
M
Department of Dermatology, Friedrich-Schiller-University of Jena, Freiburg, Germany. mirjana.ziemer@derma.uni-jena.de
Bornkessel
Anja
A
Hahnfeld
Sabine
S
Weyers
Wolfgang
W
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006562:Herpes Zoster / Q000150:complications / Q000473:pathology*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D017254:Leukemic Infiltration / Q000150:complications / Q000473:pathology*; D008297:Male; D009367:Neoplasm Staging; D012878:Skin Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D016896:Treatment Outcome; D014740:Vidarabine / Q000031:analogs & derivatives / Q000627:therapeutic use
D000970:Antineoplastic Agents; D014740:Vidarabine; C024352:fludarabine