Cedeno-Laurent F, Obstfeld A E, Boni A, Lipoff J B
Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Department of Molecular Pathology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Lupus. 2016 Mar;25(3):312-4. doi: 10.1177/0961203315611497. Epub 2015 Oct 13.
Cutaneous manifestations are often the presenting sign of internal malignancies. Up to 50% of patients with acute myeloblastic leukemia (AML) have skin findings. Connective tissue disease, particularly dermatomyositis and, rarely, lupus, have been reported as a paraneoplastic syndrome to various internal malignancies, but seldom with leukemias. We report the case of a middle-aged woman ultimately diagnosed with acute myeloblastic leukemia, who presented initially with a malar eruption, joint pains, and diffuse rash on the upper and lower extremities, with pathology consistent with lupus erythematosus and negative autoimmune serology. There are no prior reports of cutaneous lupus as the presenting sign of AML, and this case highlights the importance of considering paraneoplastic phenomena with presentations of connective tissue disease in older patients, especially with negative serology.
皮肤表现常常是体内恶性肿瘤的首发症状。高达50%的急性髓系白血病（AML）患者有皮肤表现。结缔组织病，尤其是皮肌炎，以及罕见的狼疮，已被报道为各种体内恶性肿瘤的副肿瘤综合征，但很少与白血病相关。我们报告了一例最终诊断为急性髓系白血病的中年女性病例，该患者最初表现为颧部皮疹、关节疼痛以及上下肢弥漫性皮疹，病理结果符合红斑狼疮但自身免疫血清学检查为阴性。此前尚无皮肤狼疮作为AML首发症状的报道，该病例凸显了在老年患者出现结缔组织病表现时，尤其是血清学检查为阴性时，考虑副肿瘤现象的重要性。
