Indian Journal of Dermatology
QUIZ
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


Ali Eishi Oskuie, Nasim Valizadeh 
 Department of Hematology/Medical Oncology, Urmia University of Medical Sciences, Urmia, Iran

Correspondence Address:
Nasim Valizadeh
Departmentof Hematology/Medical Oncology, Urmia University of Medical Sciences, Urmia
Iran




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;58:248-248


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 2022 Jan 26 ];58:248-248
Available from: https://www.e-ijd.org/text.asp?2013/58/3/248/110906


Full Text

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



What is your diagnosis for [Figure 1],[Figure 2],[Figure 3]?{Figure 1}{Figure 2}{Figure 3}

 Answer



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

1Kumar 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.
2Ratnam KV, Khor CJ, Su WP. Leukemia cutis. Dermatol Clin 1994;12:419.
3Bakst RL, Tallman MS, Douer D, Yahalom J. How I treat extramedullary acute myeloid leukemia. Blood 2011;118:3785.