Leukaemia Cutis: Clinical Features and Outcomes of 56 Patients

Abstract

Leukaemia is a malignant neoplasm of the haematopoietic system. Cutaneous manifestations of leukaemia are called leukaemia cutis, and are regarded as a sign of poorer prognosis and shorter survival time. A single-institution retrospective review was performed of medical records of patients diagnosed with leukaemia cutis in the dermatology department of Seoul St Mary’s Hospital between January 2012 and April 2021. Fifty-six cases with cutaneous leukaemic involvement and underlying haematological malignancy were included (40 acute myelogenous leukaemia, 8 acute lymphoblastic leukaemia, 3 chronic myeloid leukaemia, 2 chronic lymphocytic leukaemia, and 3 myelodysplastic syndrome). Male-female ratio 1.9:1, mean age at diagnosis 45.8 years. Plaques (28%) and papules (27%) were the most common skin lesions, followed by patches (18%) and nodules (16%). Mean time from diagnosis of leukaemia to development of leukaemia cutis was 12.3 months. Forty-six patients (84%) died during the 7-year follow-up; mean time from diagnosis of leukaemia cutis to death was 5.4 months. The results suggest that leukaemia cutis is associated with poor outcomes in patients with leukaemia. Comprehensive skin examination of these patients may help diagnose leukaemia cutis early, enabling prompt treatment.

Isolated leukemia cutis as extramedullary relapse of acute myeloid leukemia

“… 10 Another recent retrospective review observing patients with leukemia between 2012 and 2021 concluded that 84% of patients diagnosed with leukemia cutis ultimately died. 11 Of the patients who died, 93% died within 10 months of their diagnosis of leukemia cutis. 11 These findings are consistent with our patient who died within one month of her diagnosis.…”

“… 11 Of the patients who died, 93% died within 10 months of their diagnosis of leukemia cutis. 11 These findings are consistent with our patient who died within one month of her diagnosis.…”

“…A retrospective study examining patients between 2005 to 2007 found AML patients with leukemia cutis were 2.06 times more likely to die of leukemia, 1.66 times more likely to die of all causes, and had a worse five‐year survival in comparison with AML patients without leukemia cutis 10 . Another recent retrospective review observing patients with leukemia between 2012 and 2021 concluded that 84% of patients diagnosed with leukemia cutis ultimately died 11 . Of the patients who died, 93% died within 10 months of their diagnosis of leukemia cutis 11 .…”

Dermatological manifestations of hematologic neoplasms. Part I: secondary specific skin lesions

“… 7 , 8 The rare cases that occur before bone marrow or peripheral blood involvement, whose systemic involvement may take months to years to appear, are called aleukemic leukemias. 9 , 10 …”

“…Considering the different types of leukemias, a prevalence of LC of 10% to 15% is observed in AML, 2 , 3 , 8 , 9 of which the myelomonocytic (AMML) and monocytic (MoAL) subtypes are the most affected, in up to half of the cases. 2 , 5 , 6 In CLL, the most common presentation of systemic leukemias, LC is reported in 4% to 27% of these cases, 3 , 15 , 16 more frequently in the Richter’s syndrome, which is the rare transformation of CLL into a large cell lymphoma.…”