Riyat M S
Department of Pathology/Hematology, Nairobi Hospital, Kenya.
Int J Dermatol. 1995 Apr;34(4):249-55. doi: 10.1111/j.1365-4362.1995.tb01590.x.
Childhood leukemia and lymphoma are common problems in Tropical Africa, including Kenya. Studies done in Western populations indicate that 25-50% of patients with leukemia and lymphoma have specific or nonspecific cutaneous signs. In dark-skinned patients, reports of such mucocutaneous manifestations are scarce. The lesions in these patients may easily be missed, if not specifically looked for.
Eighty-six indigenous Kenyan children with a confirmed diagnosis of leukemia or lymphoma were specifically examined for any mucocutaneous manifestations at presentation, during their treatment, and during subsequent follow-up. Whenever possible, an attempt was made to determine the causes of these lesions. All patients were given standard therapy for the primary hematologic disorder.
Two-thirds of the patients had mucocutaneous symptomatology at presentation: 17.4% had skin infiltration by the malignant cells. During therapy an even larger number developed nonspecific skin manifestations. Most of these were the result of myelosuppression, immunosuppression, or direct cytotoxic effects on tissues.
Mucocutaneous manifestations in black children with leukemia and lymphoma are very common.
儿童白血病和淋巴瘤是包括肯尼亚在内的热带非洲地区的常见问题。在西方人群中进行的研究表明,25%至50%的白血病和淋巴瘤患者有特异性或非特异性皮肤表现。在深色皮肤患者中,关于此类黏膜皮肤表现的报道很少。如果不专门检查,这些患者的病变很容易被漏诊。
对86名确诊为白血病或淋巴瘤的肯尼亚本土儿童在就诊时、治疗期间及随后的随访中专门检查有无任何黏膜皮肤表现。只要有可能,就尝试确定这些病变的原因。所有患者均接受针对原发性血液系统疾病的标准治疗。
三分之二的患者在就诊时有黏膜皮肤症状:17.4%有恶性细胞皮肤浸润。在治疗期间,出现非特异性皮肤表现的患者更多。其中大多数是骨髓抑制、免疫抑制或对组织的直接细胞毒性作用的结果。
患有白血病和淋巴瘤的黑人儿童的黏膜皮肤表现非常常见。