The skin as a window to the blood: Cutaneous manifestations of myeloid malignancies

Li, Alvin W.; Yin, Emily S.; Stahl, Maximilian; Kim, Tae Kon; Panse, Gauri; Zeidan, Amer M.; Leventhal, Jonathan S.

doi:10.1016/j.blre.2017.07.003

Cited by 35 publications

(81 citation statements)

References 115 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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“…There are two possible pathogenic mechanisms involved in the development of EG; it either develops secondary to PA bacteremia, or it is a primary, localized skin infection without bacteremia [2]. Pseudomonas secretes enzymes such as elastase, exotoxin A, and protease, which lead to the development of necrotizing vasculitis, hemorrhage, and ulceration [1,5]. In our cases, both mechanisms were augmented.…”

Section: Discussionmentioning

confidence: 66%

“…There are no standard guidelines for the treatment. Authors agree, and it is our opinion as well, that early diagnosis, regular sampling of tissue specimens, prompt initiation of combined antibiotic therapy, knowledge of local Pseudomonas' resistance profile, as well as individual approach to each patient are of great importance [1,2,5,6].…”

Section: Discussionmentioning

confidence: 72%

“…Mostly, EG appears secondary to Pseudomonas aeruginosa (PA) bacteremia [3,4]. There are a few case reports of otherwise healthy individuals and patients without proven bacteremia where the skin lesions are considered to be primary [5]. Other pathogens, like Staphylococcus aureus, Klebsiella species, Escherichia coli, Neisseria meningitidis, Stenotrophomonas maltophilia, Aspergillus, Candida, Fusarium, and Rhizopus may also be causal agents [1].…”

Section: Introductionmentioning

confidence: 99%

“…Other pathogens, like Staphylococcus aureus, Klebsiella species, Escherichia coli, Neisseria meningitidis, Stenotrophomonas maltophilia, Aspergillus, Candida, Fusarium, and Rhizopus may also be causal agents [1]. Through a few stages, EG usually evolves from a macula or papula which progresses into a hemorrhagic bulla and a black necrotic eschar [1,2,5,6].…”

Section: Introductionmentioning

confidence: 99%

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Ecthyma gangrenosum in hematological patients - a report of two cases

et al. 2019

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Introduction. Ecthyma gangrenosum is a rare skin disorder which commonly affects immunocompromised patients. Case Report. We report two hematological patients suffering from ecthyma gangrenosum. Pseudomonas aeruginosa was isolated from skin lesions of both patients, but bacteremia was present only in the first case. These two cases had different pathogenic mechanisms and outcomes. Conclusion. Early diagnosis and prompt combination antibiotic therapy are of utmost importance in the treatment of this condition. On the other hand, the underlying disease has a great impact on the outcome as well.

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Sonographic features of secondary involvement of skin and subcutaneous tissues by hematologic malignancies

Lyu

Chen

et al. 2022

J of Clinical Ultrasound

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Objectives: To evaluate the sonographic features of secondary involvement of skin and subcutaneous tissues by hematologic malignancies.Methods: A review of the ultrasound and pathology databases yielded 10 cases with 13 skin and subcutaneous tissue lesions secondary to hematologic neoplasms, which were confirmed by pathology. We used ultrasound to assess the number, location, size, depth of involvement, echogenicity, and vascularity of the lesions. Results:The study involved five male and five female patients, including four leukemia, two multiple myeloma, and four lymphoma patients. The average age was 45 years (17-66 years). Three patients presented with one lesion, four with two

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The skin as a window to the blood: Cutaneous manifestations of myeloid malignancies

Cited by 35 publications

References 115 publications

Myeloid disorders after autoimmune disease

Myeloid disorders after autoimmune disease

Ecthyma gangrenosum in hematological patients - a report of two cases

Sonographic features of secondary involvement of skin and subcutaneous tissues by hematologic malignancies

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