Rosman Ilana S, Nunley Kara S, Lu Dongsi
Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, Missouri, USA.
Dermatol Online J. 2011 Sep 15;17(9):7.
A 53-year-old man presented with a recurrent pruritic eruption accompanied by oral sores. His past medical history was significant for subclinical B-cell chronic lymphocytic leukemia (CLL), which had never been treated. On exam, there were erythematous papules and plaques studded with vesicles on the neck, trunk, and upper extremities. Two skin biopsies showed common features of a perivascular and periadnexal lymphocytic infiltrate in the superficial to mid-dermis. Immunohistochemical staining of the lymphocytes showed co-expression of CD20, CD23, CD5, and CD43, consistent with a diagnosis of cutaneous involvement by the patient's CLL. This case highlights the importance of considering leukemia cutis in patients with underlying CLL presenting with unusual clinical features.
一名53岁男性出现复发性瘙痒性皮疹并伴有口腔溃疡。他的既往病史中有亚临床B细胞慢性淋巴细胞白血病（CLL），从未接受过治疗。检查时，颈部、躯干和上肢有红斑丘疹和斑块，散在水疱。两次皮肤活检显示在真皮浅层至中层有血管周围和附件周围淋巴细胞浸润的共同特征。淋巴细胞的免疫组化染色显示CD20、CD23、CD5和CD43共表达，符合患者CLL皮肤受累的诊断。该病例强调了在患有潜在CLL且具有不寻常临床特征的患者中考虑皮肤白血病的重要性。
