Büchner St A
Dermatologische Universitätsklinik Basel.
Praxis (Bern 1994). 2002 Jun 12;91(24):1071-7. doi: 10.1024/0369-8394.91.24.1071.
The cutaneous manifestations of leukemias are conventionally divided into nonspecific benign lesions and specific malignant lesions. Specific lesions (leukemia cutis) are localized or disseminated infiltrations of the skin by malignant leukemic cells which may involve all layers of the skin. The clinical appearance of leukemia cutis is variable and may range from papules and nodules to a generalized cutaneous eruption and erythroderma. The histopathologic examination of the skin lesion is essential for diagnosis of leukemia cutis. Specific skin lesions are usually observed in patients with an aggressive clinical course and are associated with a poor prognosis. However, an overall survival of patients with specific skin lesions of chronic lymphocytic leukemia is significantly better, as compared with other types of leukemia. Rarely, skin lesions containing leukemic cells are present before evidence of leukemia cutis can be detected in the peripheral blood and bone marrow (aleukemic leukaemia cutis). Leukemic skin lesions should be differentiated from numerous nonspecific lesions, which may be present in up to 80% of all patients with leukemia.
白血病的皮肤表现通常分为非特异性良性病变和特异性恶性病变。特异性病变(白血病性皮肤浸润)是指恶性白血病细胞对皮肤的局限性或播散性浸润,可累及皮肤各层。白血病性皮肤浸润的临床表现多样,可从丘疹和结节到全身性皮疹及红皮病。皮肤病变的组织病理学检查对白血病性皮肤浸润的诊断至关重要。特异性皮肤病变通常见于临床病程进展迅速的患者,且预后较差。然而,与其他类型白血病相比,慢性淋巴细胞白血病患者出现特异性皮肤病变后的总体生存率明显更高。极少数情况下,在外周血和骨髓中检测到白血病性皮肤浸润证据之前,皮肤病变中就已存在白血病细胞(无白血病性白血病性皮肤浸润)。白血病性皮肤病变应与众多非特异性病变相鉴别,后者在所有白血病患者中出现的比例可达80%。