Exaggerated Response to Insect Bites An Unusual Cutaneous Manifestation of Chronic Lymphocytic Leukemia

Kolbusz, Robert V.; Micetich, Kenneth C.; Armin, Ali-Reza; Massa, Mary C.

doi:10.1111/j.1365-4362.1989.tb02460.x

Cited by 28 publications

(29 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[7][8][9][10][11][12][13] Of these patients, 33 had a diagnosis of CLL and only 12 recalled being bitten by an arthropod. 7,9,11,13 Despite the histologic similarities to insect bite reactions, there are also important differences. Deep infiltrates, lymphoid nodules, and vasculitides are more common.…”

Section: Discussionmentioning

confidence: 99%

Arthropod Bites Manifesting as Recurrent Bullae in a Patient with Chronic Lymphocytic Leukemia

Blum

Phelps

Wei

2001

Journal of Cutaneous Medicine and Surgery: Incorporating Medica

View full text Add to dashboard Cite

Emphasis needs to be placed on the clinical recognition of arthropod bites as an unusual cutaneous manifestation of CLL, as they provide the physician with both a diagnostic and a therapeutic challenge. Patients often deny being bitten and, thus, the biopsy results conflict with the patient's history. Additionally, as there is no specific treatment, both the patient and physician are faced with a similar dilemma. Although our patient initially responded well to corticosteroids, his lesions significantly improved while being treated with dapsone.

show abstract

Section: Discussionmentioning

confidence: 99%

Arthropod Bites Manifesting as Recurrent Bullae in a Patient with Chronic Lymphocytic Leukemia

Blum

Phelps

Wei

2001

Journal of Cutaneous Medicine and Surgery: Incorporating Medica

View full text Add to dashboard Cite

show abstract

“…However, this can merely be a reflection of the distribution of neoplastic cells in the blood and their capability to respond to immunologic stimuli. 21 In all the published cases of insect bite-like reaction, 3,[5][6][7]9 the eruption was unrelated to laboratory findings, disease course, or therapy given. This is also the trend in the present series.…”

Section: Patient Characteristics and Clinical Data On The Insect Bitementioning

confidence: 99%

Insect Bite–like Reaction in Patients With Hematologic Malignant Neoplasms

Barzilai¹,

Shpiro²,

Goldberg³

et al. 1999

Arch Dermatol

115

195

View full text Add to dashboard Cite

Background: Exaggerated reaction to insect bites, mainly to mosquitoes, is infrequently described in patients with chronic lymphocytic leukemia. Skin lesions usually appear months to years after the diagnosis of leukemia and are unrelated to laboratory findings, disease course, or therapy.Observations: We describe 8 patients with various hematologic disorders (chronic lymphocytic leukemia, acute lymphoblastic leukemia, acute monocytic leukemia, mantle-cell lymphoma, large-cell lymphoma, and myelofibrosis) who developed insect bite-like reaction. Although the clinical picture and the histological characteristics of the lesions were typical for insect bites, none of the patients actually had a history, course, or response to treatment suggestive of arthropod assaults. In 2 patients, the eruption preceded the diagnosis of the ma-lignant neoplasm. The rash persisted for months to years and was resistant to therapies other than systemic corticosteroids. The 3 patients with chronic lymphocytic leukemia seemed to have a worse prognosis than expected for their disease. In 1, the polymerase chain reaction detected leukemic cells in the infiltrate.Conclusions: Insect bite-like reaction is an infrequent, disturbing, and difficult-to-treat nonspecific phenomenon in patients with hematologic malignant neoplasms. Since it may precede the hematologic disorder, oriented evaluation is warranted. We speculate that immunodeficiency plays a role in its pathogenesis; however, the exact pathogenesis and its prognostic implications await further studies.

show abstract

“…The reactions peaked at 12-24 h. However, more recent studies have reported that most patients with these reactions do not recall being bitten. Furthermore, lesions are often not restricted to exposed sites, show no seasonal variation, and apparently occur even when people take precautions (protective clothing, avoiding outdoor activity, using insect repellant) (5)(6)(7)(8)(9), suggesting that the reaction may not be triggered by a bite. Accordingly, Barzilai et al (10) proposed that the term 'exaggerated reaction of insect bite' used by Weed (4) be replaced with 'insect-bite-like reaction' or 'eosinophilic eruption of hematoproliferative disease.'…”

mentioning

confidence: 99%

Insect‐bite‐like reaction in patients with chronic lymphocytic leukemia: a study from the Israeli Chronic Lymphocytic Leukemia Study Group

Bairey

Goldschmidt

Ruchlemer

et al. 2012

European J of Haematology

View full text Add to dashboard Cite

An insect-bite-like reaction is known to occur in patients with chronic lymphocytic leukemia (CLL). Most of the literature, however, consists of isolated case reports or small case series. The aim of this retrospective study was to review the national experience with insect-bite-like reaction in a large group of patients with CLL. The study cohort of patients with these skin reactions consisted of 48 patients (25 males, 23 females) of mean age 64.8 yr (range 33-89) at skin eruption. Data on clinical, histologic, immunophenotypic, and cytogenetic characteristics, treatment, and outcome were collected from the medical files. Mean time between diagnosis of CLL and appearance of the skin lesions was 3.1 yr (range -4 to 14 yr). The eruption was not related to disease activity or the course of the hematological disease. The eruption preceded the diagnosis of CLL in 10 patients (by 0-4 yr); and followed the diagnosis in 36; in 11 patients, it occurred during therapy for CLL and in nine after therapy. Mean duration of the skin findings was 21.5 months (range 0.3-132). The eruption usually presented in summer, although it occurred also at other times of the year, and predominantly affected the upper and lower limbs, although it also appeared on unexposed areas. Treatment included local ointments, antihistaminics, oral steroids, antibiotics, phototherapy, and dapsone with varying responses. Insect-bite-like reactions is a relatively common and disturbing skin reaction in CLL patients, it may be related to the immune dysregulation accompanying CLL and further exacerbated by external factors, including actual insect bites, chemoimmunotherapy, and pyogenic infection.

show abstract

Exaggerated Response to Insect Bites An Unusual Cutaneous Manifestation of Chronic Lymphocytic Leukemia

Cited by 28 publications

References 2 publications

Arthropod Bites Manifesting as Recurrent Bullae in a Patient with Chronic Lymphocytic Leukemia

Arthropod Bites Manifesting as Recurrent Bullae in a Patient with Chronic Lymphocytic Leukemia

Insect Bite–like Reaction in Patients With Hematologic Malignant Neoplasms

Insect‐bite‐like reaction in patients with chronic lymphocytic leukemia: a study from the Israeli Chronic Lymphocytic Leukemia Study Group

Contact Info

Product

Resources

About