Histologic Spectrum of Cutaneous Involvement in Patients With Myelogenous Leukemia Including the Neutrophilic Dermatoses

Abstract

Awareness of these different morphologic features and application of special stains are of value in the evaluation of suspicious cutaneous infiltrates in patients with myeloid leukemia and various myeloproliferative disorders.

Abscess-Forming Neutrophilic Dermatosis: Report of Three Cases Associated with Hemopathies

“…Recently, the serum levels of G-CSF or GM-CSF have been suspected to have some relationship with neutrophilic abnormalities in myeloproliferative diseases [4, 6, 11, 12, 13]. Confirming the close relationship between the abscess-forming neutrophilic dermatosis and underlying myelodysplastic disorder, the serum value of G-CSF was significantly elevated in case 3.…”

“…Although the detailed mechanisms of these diseases are unknown, a role of hematopoietic cytokines, such as granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF), has been suggested. These factors are synthesized by fibroblasts, macrophages and endothelial cells, or administered for the treatment of primary cytopenic bone marrow conditions [4, 6, 11, 12, 13]. Abnormally stimulated neutrophils may accumulate in the connective tissues leading to inflammatory episodes.…”

“…Myelodysplastic syndrome (MDS) and other hematological disorders, such as leukemia or more rarely myeloma, have recently been recognized to be associated with skin diseases characterized by a neutrophilic infiltration in the dermis, which clinically resembles acute febrile neutrophilic dermatosis (Sweet’s syndrome) or pyoderma gangrenosum [1, 2, 3, 4, 5, 6], erythema elevatum et diutinum [7, 8]and neutrophilic eccrine hidradenitis [9, 10]. Although the detailed mechanisms of these diseases are unknown, a role of hematopoietic cytokines, such as granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF), has been suggested.…”

Vaginal Ulcers as Initial Presentation of Subacute Myelomonocytic Leukemia

“…These eruptions may be due to bacterial, viral and fungal infections secondary to immunosuppression or hemorrhagic diathesis resulting in petechiae, purpura and ecchymoses. Another group of disorders can be characterized by neutrophilic infiltrates of the skin and constitute the neutrophilic dermatoses [7]: pyoderma gangrenosum, Sweet’s syndrome, subcorneal pustular dermatosis of Sneddon-Wilkinson and erythema elevatum diutinum. The neutrophilic dermatoses are also associated with a poor prognosis in myelodysplastic syndrome [8].…”

Cutaneous Hematopathology

“…Patients with an underlying myeloid disorder can develop specifi c (clonal, malignant) or nonspecifi c (reactive, benign) cutaneous lesions (Bluefarb and Webster 1953 ;Wong et al 1995 ). Lesions that are specifi c are those in which the skin is involved by myelomonocytic leukemic cells and show histological changes compatible with leukemia cutis (LC).…”