Bilateral cauliflower ear as the presenting sign of B‐cell chronic lymphocytic leukemia

Bilateral Auricular Involvement: A Rare Presenting Sign of Chronic Lymphocytic Leukemia, and Successful Treatment with Electron Beam Therapy

“…Cutaneous lesions in CLL localized exclusively to the bilateral ears have been only exceptionally reported (2)(3)(4)(5)(6). Leukemia cutis on the ears usually occurs in older patients with known or late-stage CLL, but as seen in our case, it can be the heralding feature in a young patient with otherwise subclinical disease.…”

“…The differential diagnosis of bilateral auricular lesions includes infectious (leprosy, leishmaniasis, tuberculosis), neoplastic (primary lymphoma, lymphocytoma cutis, Rosai-Dorfman disease, multicentric reticulohistiocytosis), and miscellaneous (sarcoidosis, perniosis, relapsing polychondritis, auricular pseudocyst, trauma/ hematoma) skin disease (2). Cutaneous lesions in CLL localized exclusively to the bilateral ears have been only exceptionally reported (2)(3)(4)(5)(6).…”

“…Lesions of leukemia cutis tend to occur late in the disease with nonspecific, isolated or grouped erythematous or violaceous papulonodules and/or plaques that are typically located on the head and neck. The lesions may mimic other conditions such as granulomatous rosacea or rhinophyma when localized on the central face or present on the bilateral helices and/or earlobes (2). Herein we present the first case of bilateral auricular involvement treated successfully with involved field electron beam therapy.…”

B-cell chronic lymphocytic leukemia with bilateral ear involvement

“…In the literature, bilateral ear involvement as an initial presentation of CLL-B, mimicking a red rosary or cauliflower, is exceptional, but characteristic. 1,2…”