title: Lupus-like eruption as the presenting sign of acute myeloblastic leukemia.
abstract: Cutaneous manifestations are often the presenting sign of internal malignancies. Up to 50% of patients with acute myeloblastic leukemia (AML) have skin findings. Connective tissue disease, particularly dermatomyositis and, rarely, lupus, have been reported as a paraneoplastic syndrome to various internal malignancies, but seldom with leukemias. We report the case of a middle-aged woman ultimately diagnosed with acute myeloblastic leukemia, who presented initially with a malar eruption, joint pains, and diffuse rash on the upper and lower extremities, with pathology consistent with lupus erythematosus and negative autoimmune serology. There are no prior reports of cutaneous lupus as the presenting sign of AML, and this case highlights the importance of considering paraneoplastic phenomena with presentations of connective tissue disease in older patients, especially with negative serology.
authors.affiliation: Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
authors.forename: F
authors.initials: F
authors.lastname: Cedeno-Laurent
authors.affiliation: Department of Molecular Pathology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
authors.forename: A E
authors.initials: AE
authors.lastname: Obstfeld
authors.affiliation: Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
authors.forename: A
authors.initials: A
authors.lastname: Boni
authors.affiliation: Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA jules.lipoff@uphs.upenn.edu.
authors.forename: J B
authors.initials: JB
authors.lastname: Lipoff
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008178:Lupus Erythematosus, Cutaneous / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012867:Skin / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids
keywords: Lupus; connective tissue disease; leukemia; paraneoplastic