title: Bullous leukemia cutis mimicking facial cellulitis.
abstract: Bullous leukemia cutis is an uncommon clinical manifestation of cutaneous infiltration by leukemic cells, from B-cell chronic lymphocytic leukemia. We present the case of a 67-year-old, female, chronic lymphocytic leukemia patient. She was taking chlorambucil and developed facial edema with erythema and warmth, misjudged as facial cellulitis. Two days later, she developed bullous lesions in the arms, legs, neck and face. The histopathology of facial and bullous lesions confirmed leukemia cutis. All lesions disappeared following the administration of rituximab combined with cycles of fludarabine and cyclophosphamide. Although soft tissue infections are common complications in patients undergoing chemotherapy, leukemia cutis can also resemble cellulitis.
authors.affiliation: Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
authors.forename: Luciana de Sales
authors.initials: Lde S
authors.lastname: Caldato
authors.affiliation: Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
authors.forename: Juliana de Sousa
authors.initials: Jde S
authors.lastname: Britto
authors.affiliation: Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
authors.forename: Ligia
authors.initials: L
authors.lastname: Niero-Melo
authors.affiliation: Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
authors.forename: Hélio Amante
authors.initials: HA
authors.lastname: Miot
mesh_terms: D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D002481:Cellulitis / Q000473:pathology*; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005148:Facial Dermatoses / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007945:Leukemia, Lymphoid / Q000188:drug therapy / Q000473:pathology*; D017254:Leukemic Infiltration / Q000188:drug therapy / Q000473:pathology*; D012872:Skin Diseases, Vesiculobullous / Q000188:drug therapy / Q000473:pathology*
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide