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Year : 2013  |  Volume : 58  |  Issue : 3  |  Page : 248
A 78-year-old female was admitted with respiratory distress and nodular erythematous to violaceous lesions on her face


Department of Hematology/Medical Oncology, Urmia University of Medical Sciences, Urmia, Iran

Date of Web Publication20-Apr-2013

Correspondence Address:
Nasim Valizadeh
Departmentof Hematology/Medical Oncology, Urmia University of Medical Sciences, Urmia
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.110906

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How to cite this article:
Oskuie AE, Valizadeh N. A 78-year-old female was admitted with respiratory distress and nodular erythematous to violaceous lesions on her face. Indian J Dermatol 2013;58:248

How to cite this URL:
Oskuie AE, Valizadeh N. A 78-year-old female was admitted with respiratory distress and nodular erythematous to violaceous lesions on her face. Indian J Dermatol [serial online] 2013 [cited 2019 May 23];58:248. Available from: http://www.e-ijd.org/text.asp?2013/58/3/248/110906


A 78-year-old woman with history of acute myeloid leukemia (AML-M4) since 5 months ago was admitted with diffuse skin infiltration and dyspnea. Physical examination showed tachycardia, tachypnea, nodular erythematous to violaceous lesions on her face [Figure 1] and [Figure 2], trunk and abdomen [Figure 3], and bilateral respiratory rales. Electrocardiogram (ECG) showed sinus tachycardia. Laboratory findings included the following: White blood cell count (WBC) = 133,300/μL (myeloblast = 46%, monoblast = 34%, neutrophil = 15%, lymphocyte = 5%), Hb = 8.9 gr/dl, and platelet count = 62,000/μl. The patient died due to respiratory failure.


   Question Top


What is your diagnosis for [Figure 1],[Figure 2],[Figure 3]?
Figure 1: Skin lesions on her face

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Figure 2: Skin lesions on her face from lateral view

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Figure 3: Skin lesions on her abdomen

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   Answer Top


Leukemia Cutis.

The diagnosis of leukemia cutis and respiratory distress due to leukostasis was made.

Leukemia cutis is infiltration of leukemic cells in epidermis, dermis, and subcutis. The majority of cases are seen in AML especially in AML-M4 and -M5 subtypes. [1],[2],[3] In this 78-year-old female with AML-M4, we saw diffuse skin involvement by leukemic cells that leaded to a bizarre appearance in her face.

 
   References Top

1.Kumar L, Singh S, Gupta A, Agarwal S, Dua H, Karak A, et al. Skin involvement in leukemia. J Assoc Physicians India. 1989;37:217-8.  Back to cited text no. 1
    
2.Ratnam KV, Khor CJ, Su WP. Leukemia cutis. Dermatol Clin 1994;12:419.  Back to cited text no. 2
    
3.Bakst RL, Tallman MS, Douer D, Yahalom J. How I treat extramedullary acute myeloid leukemia. Blood 2011;118:3785.  Back to cited text no. 3
    


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  [Figure 1], [Figure 2], [Figure 3]



 

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