Leukemia cutis originating in the extravasation site of i.v. gabexate mesilate infusion.
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.
Miyakura
Takashi
T
Department of Dermatology, Tokyo Medical University, Tokyo, Japan. miyakura@tokyo-med.ac.jp
Yamamoto
Toshiyuki
T
Kurashige
Yuta
Y
Nagai
Ayako
A
Iguchi
Tomotaka
T
Aota
Yasuo
Y
Tsuboi
Ryoji
R
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
D000925:Anticoagulants; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D016670:Gabexate