Reactive granulomatous dermatitis presenting as subcutaneous nodules and cords in a patient with advanced myelodysplastic syndrome

Weed, Jason G.; Ko, Christine J.; Stahl, Maximilian; Much, Melissa A.; Witt, David H.; Zeidan, Amer M.; Leventhal, Jonathan S.

doi:10.1007/s00277-017-2954-5

Cited by 9 publications

(13 citation statements)

References 11 publications

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“…An increased incidence of AML has been reported across several AD types such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), polymyalgia rheumatica, ankylosing spondylitis, autoimmune hemolytic anemia, systemic vasculitides, pernicious anemia, multiple sclerosis (MS), and inflammatory bowel disease (IBD). (23)(24)(25) (26)(27)(28) Interestingly, autoimmune diseases develop in as many as 10% of patients with MDS and MPNs. (29) MDS/MPN-associated AD entities include the vasculitides, Behcet's disease, IBD, glomerulonephritides, neutrophilic dermatoses, hemolytic anemia, and immune thrombocytopenia.…”

Section: Introductionmentioning

confidence: 99%

Myeloid disorders after autoimmune disease

Boddu

Zeidan

2019

Best Practice & Research Clinical Haematology

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Autoimmune diseases (ADs) are associated with an increased risk not only of lymphoproliferative disorders but also of myeloid malignancies. The excess risk of myelodysplastic syndromes and/or acute myeloid leukemia is observed across several AD types, including systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disorders, multiple sclerosis, among others. The risk of developing myeloid neoplasms (MNs) is dependent on several variables, including the specific AD type, chronicity and severity of the AD, type and duration of exposure of disease modifying anti-rheumatic drugs or cytotoxics/immunosuppressives, and genetic predisposition among others. Putative triggering factors linking AD to elevated MN risk include AD-directed medications, shared genetic susceptibilities between the two disease entities, and chronic immune stimulation or bone marrow infiltration by the AD. Molecular mechanisms underpinning leukemogenesis remain largely speculative and warrant further investigation. Leukemias arising in patients with AD are not always 'therapy-related' in that MNs may develop in certain AD subtypes even among patients with no prior therapy exposure. Only a few studies have attempted to determine factors associated with MN development in AD but failed to demonstrate consistent characteristic clinical or paraclinical features. These reports have failed to demonstrate a clear correlation between individual agent exposure and subsequent leukemia development due to the low rates of therapy exposure compounded by the rarity of MN occurrence. Notwithstanding, the leukemogenic potential is best documented with agents such as azathioprine, cyclophosphamide, and mitoxantrone; this risk of MN development does not appear to be shared by biologic approaches such as anti-tumor necrosis factors-alpha inhibitors. In this article, we discuss plausible biologic mechanisms underpinning MN pathogenesis in AD and review the data available on the development of MNs in AD patients.

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Section: Introductionmentioning

confidence: 99%

Myeloid disorders after autoimmune disease

Boddu

Zeidan

2019

Best Practice & Research Clinical Haematology

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“…6 In summary, we present a case of reactive, non-interstitial granulomatous dermatitis that appeared 1 year prior to MDS, treated with hydroxychloroquine. To our knowledge, this case is the fourth reported case of non-interstitial granulomatous dermatitis associated with MDS 1,2,5 and the first to be treated with hydroxychloroquine long-term. It is also noteworthy for a lack of progression to AML during 1 year of follow-up, despite the presence of granulomatous dermatitis.…”

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confidence: 85%

“…3 Previous cases of MDS-associated reactive granulomatous dermatitis have been treated with lenalidomide or a combination of prednisone and colchicine. 1,2,5 In our case, the decision was made to use hydroxychloroquine as the sole therapeutic agent given its efficacy in other granulomatous conditions such as granuloma annulare and sarcoidosis, and because of its high safety profile, whereas immunosuppressive medications posed a greater risk of infection in this patient with high-risk MDS.…”

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Treatment of myelodysplasia‐associated reactive, non‐interstitial granulomatous dermatitis with hydroxychloroquine

et al. 2022

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Nonvenereal sclerosing lymphangitis of the penis with involvement of the glans: first description Dear Editor, Nonvenereal sclerosing lymphangitis of the penis is a benign, transient lymphangiectasis of the penis most likely consequent to intense sexual activity. The pathology is clinically expressed in the form of a hard, painful, and willingly translucent cord of the sulcus of the glans.We describe a particular form of nonvenereal sclerosing lymphangitis with serpiginous involvement of the glans.

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confidence: 90%