Chao S C, Lee J Y, Tsao C J
Department of Dermatology, National Cheng-Kung University Hospital, Taiwan, ROC.
J Dermatol. 1999 Apr;26(4):216-9. doi: 10.1111/j.1346-8138.1999.tb03459.x.
Leukemia cutis is a specific skin lesion caused by infiltration of leukemic cells into the skin. It is uncommon in acute lymphocytic leukemia (ALL). It typically manifests as red or violaceous papules, nodules, or plaques, mainly on the face. Leukemia cutis presenting with a generalized viral exanthem-like maculopapular eruption appears to be rare in the English literature. We report such a case. A 19 year-old man presented with a generalized purpuric maculopapular eruption of eight day's duration. Hematologic studies showed changes of acute lymphocytic leukemia, T-cell type. A skin biopsy specimen revealed a cuff-like, dense, perivascular infiltration of atypical lymphocytes in the upper and mid-dermis, consistent with leukemia cutis. The rash resolved in two weeks after chemotherapy. Our case illustrates that leukemia cutis should be considered in the differential diagnosis of a generalized morbilliform viral exanthem-like eruptions. Skin biopsy is important in establishing the diagnosis.
皮肤白血病是白血病细胞浸润皮肤引起的一种特异性皮肤损害。在急性淋巴细胞白血病（ALL）中并不常见。其典型表现为红色或紫色丘疹、结节或斑块，主要出现在面部。在英文文献中，表现为全身性病毒疹样斑丘疹的皮肤白血病似乎很罕见。我们报告这样一例病例。一名19岁男性出现持续8天的全身性紫癜性斑丘疹。血液学检查显示为急性淋巴细胞白血病（T细胞型）的改变。皮肤活检标本显示在真皮上部和中部有非典型淋巴细胞呈袖口样、密集的血管周围浸润，符合皮肤白血病。皮疹在化疗后两周内消退。我们的病例表明，在鉴别诊断全身性麻疹样病毒疹样皮疹时应考虑皮肤白血病。皮肤活检对确诊很重要。
