title: Cutaneous leukemic infiltration following varicella - a case of Wolf's isotopic response.
abstract: Wolf's isotopic response designates the appearance of two subsequent unrelated dermatoses in the same anatomic location. We report the case of a 51-year-old man with a medical history of chronic lymphocytic leukemia without known extra-hematopoietic involvement. The patient developed a disseminated papulo-vesiculous eruption, diagnosed as varicella. Few days after recovering, an erythematous and violaceous papular dermatosis with histopathological examination compatible with leukemic infiltration appeared on the scars of previous herpetic lesions. Complete remission was obtained under systemic corticotherapy, without cutaneous recurrence or blastic transformation. Wolf's isotopic response is attributed to a localized immunologic imbalance following a certain stimulus. In this patient, herpetic infection acted as a local spur for inaugural cutaneous leukemic infiltration, with no impact on the prognosis for the underlying disease.
authors.affiliation: Hospital S. António Capuchos - Centro Hospitalar Lisboa Central - Lisbon, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Brasileiro
authors.affiliation: Hospital S. António Capuchos - Centro Hospitalar Lisboa Central - Lisbon, Portugal.
authors.forename: André
authors.initials: A
authors.lastname: Lencastre
authors.affiliation: Hospital S. António Capuchos - Centro Hospitalar Lisboa Central - Lisbon, Portugal.
authors.forename: Alexandre
authors.initials: A
authors.lastname: João
authors.affiliation: Hospital S. António Capuchos - Centro Hospitalar Lisboa Central - Lisbon, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Fidalgo
mesh_terms: D002644:Chickenpox / Q000188:drug therapy / Q000473:pathology*; D020405:Dermis / Q000473:pathology; D006562:Herpes Zoster / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000473:pathology*; D017254:Leukemic Infiltration / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology*; D017193:Skin Diseases, Viral / Q000188:drug therapy / Q000473:pathology*; D016896:Treatment Outcome