Leukemia cutis originating in the extravasation site of i.v. gabexate mesilate infusion

Miyakura, Takashi; Yamamoto, Toshiyuki; Kurashige, Yuta; Nagai, Ayako; Iguchi, Tomotaka; Aota, Yasuo; Tsuboi, Ryoji

doi:10.1111/j.1346-8138.2007.00407.x

Cited by 6 publications

(1 citation statement)

References 9 publications

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“…Case 1 presented with typical clinical features of bullous PG. In Case 2, we at first suspected myeloma cells infiltration in the skin, because previous reports showed that leukemia cells recruited to the sites of leakage of a drip infusion on the forearm [3]. However, histological features denied atypical cells and demonstrated PG.…”

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Bullous pyoderma gangrenosum in patients with ulcerative colitis and multiple myeloma

Takenoshita¹,

Yamamoto²

2014

Our Dermatol Online

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Letter to the Editor Sir, Bullous pyoderma gangrenosum (PG) is a rare subtype of PG, which frequently involves extremities. We herein report two cases of bullous PG in association with other systemic diseases, such as hematological malignancy and inflammatory bowel disease. Case 1 A 52-year-old man suffered from stomachache, diarrhea, and bloody stools for some months, and was diagnosed with ulcerative colitis (UC) by colonoscopy examination. Biopsy specimens showed inflammatory cell infiltration in the mucosal epithelium. Almost simultaneously, he developed bullous lesions on the lower legs. Physical examination showed rounded, edematous bloody bullous lesions on the bilateral shin (Fig. 1). Laboratory examination showed increased levels of C-reactive protein (CRP; 3.12 mg/dl) and erythrocyte sedimentation rate (53 mm/h), and white blood cell counts (8900/mm3) with 70% neutrophils. Histological examination showed subepidermal bulla and neutrophil and mononuclear cell infiltration in the mid-to lower dermis. After admission, systemic prednisolone (30 mg/day) was administered for intestinal lesions, which also improved skin lesions. Case 2 A 76-year-old man was suffering from multiple myeloma for 8 years. He had been treated with chemotherapies (ranimustine, vincristine, melphalan, dexamethasone), which however could not lead to remission induction. During the course, he was hospitalized and consulted to dermatology department, as for the skin lesions on his forearm. Physical examination revealed hemorrhagic bullae on the left forearm (Fig. 2). Laboratory examination showed increased levels of CRP (14.7 mg/dl). A biopsy specimen revealed prominent red blood cells, diffuse neutrophil infiltration in the entire dermis (Fig. 3). There were no atypical cells. He was initially treated with antibiotics without effects, but successfully treated with oral prednisolone (30 mg/day).

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