076 Senescent fibroblasts enhance squamous cell carcinoma progression through secretion of Chemerin and activation of MAPK pathway

Abstract

T-cell prolymphocytic leukemia (T-PLL) is a rare neoplasm of mature T lymphocytes. Cutaneous involvement, e.g., leukemia cutis (LC), is a characteristic symptom of T-PLL and appears in up to one-third of cases. LC may follow, precede or occur concomitantly with the diagnosis of systemic leukemia, however, vesiculo-bullous LCs are rare. So far, few were reported in chronic lymphocytic leukemia, but none in T-PLL. T-PLL is a relatively unknown disease in the field of dermatology, and moreover, variable leukemic cutaneous manifestations, especially the non-specific lesions of bullous LC, make it clinically difficult to distinguish from other non-specific lesions. We report here a case of leukaemia cutis with vesiculo-bullous lesions in a patient who was recently diagnosed with T-PLL and has been on chemotherapy. A skin biopsy specimen showed dense infiltration of small lymphocytes in the dermis, and subsequent immunogenotyping confirmed the presence of leukemia cells in the same patterns of previous biopsies of the lymph node. To our knowledge, this is the first report of vesiculo-bullous LC in a patient with T-PLL. LC is an indicator of poor prognosis and often requires more aggressive therapies. Proper diagnosis of LC is essential because it can alter the appropriate treatment for a patient.