title: Leukemia cutis originating in the extravasation site of i.v. gabexate mesilate infusion.
abstract: Leukemia cutis is a localized or disseminated skin infiltration by leukemic cells. A 64-year-old man was diagnosed with acute myeloid leukemia (AML) complicated by disseminated intravascular coagulation. During the course of treatment with gabexate mesilate, the substance accidentally leaked from the infusion site in his elbow. One month later, a dark red erythema and induration accompanied by severe pain appeared in the area proximal to the gabexate mesilate injection site. The biopsy specimen demonstrated not only inflammation but infiltration of leukemic cells as well. Immunohistochemical staining for intercellular adhesion molecule-1 and platelet/endothelial cell adhesion molecule-1 showed strong expression of endothelial cells and leukemic cells. We speculate that the gabexate mesilate might have played a role in the induction of leukemia cutis via adhesion molecules in our case.
authors.affiliation: Department of Dermatology, Tokyo Medical University, Tokyo, Japan. miyakura@tokyo-med.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyakura
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yuta
authors.initials: Y
authors.lastname: Kurashige
authors.forename: Ayako
authors.initials: A
authors.lastname: Nagai
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Iguchi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Aota
authors.forename: Ryoji
authors.initials: R
authors.lastname: Tsuboi
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects*; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications*; D016670:Gabexate / Q000009:adverse effects*; D006801:Humans; D007150:Immunohistochemistry; D007262:Infusions, Intravenous / Q000009:adverse effects; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D015470:Leukemia, Myeloid, Acute / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D012867:Skin / Q000293:injuries; D012878:Skin Neoplasms / Q000209:etiology* / Q000378:metabolism / Q000473:pathology
chemical_list: D000925:Anticoagulants; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D016670:Gabexate