Background: Although atopic dermatitis (AD) is becoming a pressing public health concern in the world, Madagascar is underrepresented in the AD literature.

Rationale: Systemic lupus erythematosus (SLE) represents a risk of malignancy. The mechanism of carcinogenesis is not fully elucidated. Lymphomas are the most reported cancers in lupus. Other hemopathies have been reported, such as leukemia but remain unusual. Patient concerns: We report a 30-year-old woman with SLE diagnosed 20 months ago associated with end-stage renal disease and active hepatitis B. She was treated with hydroxychloroquine and azathioprine, followed by methotrexate. During follow-up, she presented persistent anemia, leukopenia and thrombocytopenia. Diagnoses: Following these cytopenias, a bone marrow aspiration was performed. Acute myeloid leukemia associated with SLE was diagnosed. Interventions: She received transfusion support and corticosteroid therapy. Methotrexate was stopped and hydroxychloroquine was continued. The patient was not eligible for chemotherapy because of her comorbidities. Outcomes: Cytopenias were worsening and unfortunately, she died 3 months later Lessons: This observation highlights the importance of regular blood count monitoring during SLE. In case of persistent cytopenia, bone marrow aspiration should be performed to look for an associated hematological malignancy.