Diffuse and Progressive Papules and Nodules
Christine M. Adamick, MD;
Debra L. Breneman, MD
University of Cincinnati, Cincinnati, Ohio
Arch Dermatol. 2000;136:791-796.
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REPORT OF A CASE
A previously healthy 67-year-old white man presented with a 10-week history of a diffuse asymptomatic cutaneous eruption that began on his trunk and progressed to involve his extremities. His primary care physician initially treated him with topical corticosteroids for presumed dermatitis, with continued worsening of his disease. A review of systems revealed mild fatigue and a 4.5-kg weight loss over a 3-month period.
Physical examination revealed diffusely scattered erythematous and violaceous smooth-surfaced papules and nodules (Figure 1). A biopsy specimen was obtained from a lesion on the right flank (Figure 2 and Figure 3).
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Figure 1.
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Figure 2.
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Figure 3.
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What is your diagnosis?
Diagnosis: Acute myelogenous leukemia presenting in the skin (leukemia cutis).
Microscopic examination revealed a dense dermal infiltrate consisting of moderately sized atypical monocytoid cells exhibiting pleomorphism, necrosis, and mitotic figures, features characteristic of leukemia cutis. The white blood cell count was higher than 90 . . . [Full Text of this Article]
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