Leukemia Cutis—The Current View on Pathogenesis, Diagnosis, and Treatment

Abstract

Leukemia cutis (LC) is defined as the leukemic infiltration of the epidermis, the dermis, and the subcutaneous tissue. Leukemia cutis may follow or occur simultaneously with the diagnosis of systemic leukemia. However, cutaneous lesions are occasionally diagnosed as the primary manifestation of leukemia. Leukemic skin infiltrations demonstrate considerable variation regarding a number of changes, distribution, and morphology. The highest incidence of LC is observed in chronic lymphocytic leukemia, monocytic and myelomonocytic acute myeloid leukemia, and T-cell lineage leukemia. Although the pathogenic mechanism of the invasion of leukemic cells into the skin is not well understood, chemokine receptors and adhesion molecules as well as the genetic characteristics of leukemia are thought to play a role. Leukemic skin lesions may be localized or disseminated and may occur alone or in combination on any site of the skin, most frequently in the trunk and extremities. The most common clinical presentations of leukemia cutis are papules, nodules, macules, plaques, and ulcers. In most patients, the complete or partial resolution of cutaneous infiltrations occurs simultaneously with hematologic remission. However, in patients with resistant disease or recurrent skin infiltration, local radiotherapy can be used. This review presents recent data on the pathogenesis, diagnosis, and treatment of leukemic skin involvement in different types of leukemia.

Leukemia cutis revealing relapse of a chronic myeloid leukemia: A case report

“…LC is less commonly described in adults, 7 particularly in the case of CML. Moreover, the appearance of LC is generally linked to a transformation into a blastic phase, reflecting the progression of the disease, 3 which is not the case here. In our case, there were no additive cutaneous manifestations of bone marrow insufficiency relative to cytopenia that can occur and which may be rigorously interpreted.…”

“…1 LC is an uncommon condition depending on the subtypes of leukemia that involve the skin, whether myeloid or lymphoid disorders and is more commonly described in patients with acute myeloid leukemia (AML) but may also be seen with chronic myeloid leukemia (CML), acute or chronic lymphocytic leukemia, and myelodysplastic syndrome. [1][2][3][4] It appears to correlate with the progression of leukemia and is concomitant in a large majority of with other associated extramedullary involvement but may occasionally be diagnosed synchronously or months to year before the hematological disease onset and refers to aleukemic LC. 5,6 Etiopathogenesis behind the skin neoplastic leukocyte migration remains unclear but mechanisms involving chemotaxis have been suggested; referring to the concept of skin selective homing.…”

“…Leukemia cutis (LC) refers to neoplastic leukocyte infiltration within the skin and encompasses various forms including myeloid sarcomas, chloromas, or monoblastic sarcomas, each differing in their neoplastic precursors 1 . LC is an uncommon condition depending on the subtypes of leukemia that involve the skin, whether myeloid or lymphoid disorders and is more commonly described in patients with acute myeloid leukemia (AML) but may also be seen with chronic myeloid leukemia (CML), acute or chronic lymphocytic leukemia, and myelodysplastic syndrome 1–4 . It appears to correlate with the progression of leukemia and is concomitant in a large majority of with other associated extramedullary involvement but may occasionally be diagnosed synchronously or months to year before the hematological disease onset and refers to aleukemic LC 5,6 .…”