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Related Experiment Videos

Insect bite-like reaction in patients with hematologic malignant neoplasms.

A Barzilai1, D Shpiro, I Goldberg

  • 1Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Israel. aviv@post.tau.ac.il

Archives of Dermatology
|December 22, 1999
PubMed
Summary

Patients with hematologic cancers may experience exaggerated insect bite-like reactions. This reaction can appear before cancer diagnosis and may indicate a worse prognosis, suggesting a link to immunodeficiency.

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Area of Science:

  • Dermatology
  • Hematology
  • Oncology

Background:

  • Exaggerated reactions to insect bites are rarely reported in patients with chronic lymphocytic leukemia (CLL).
  • Skin lesions typically manifest months to years post-leukemia diagnosis, independent of disease status or treatment.
  • This phenomenon is also observed in other hematologic malignancies.

Purpose of the Study:

  • To describe the clinical presentation and characteristics of insect bite-like reactions in patients with hematologic disorders.
  • To investigate the potential association between these reactions and the underlying hematologic malignancy.
  • To explore the diagnostic and prognostic implications of this phenomenon.

Main Methods:

  • Case series describing 8 patients with various hematologic disorders experiencing insect bite-like reactions.

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  • Clinical and histological evaluation of skin lesions.
  • Review of patient history, disease course, and treatment response.
  • Polymerase chain reaction (PCR) used in one case to detect leukemic cells.

    • Main Results:

    • Patients presented with lesions clinically and histologically resembling insect bites, but without a history of actual insect assault.
    • In two cases, the rash preceded the diagnosis of a hematologic malignancy.
    • Lesions were persistent, lasting months to years, and resistant to most treatments except systemic corticosteroids.
    • Three patients with CLL showed a poorer prognosis than anticipated; leukemic cells were found in the infiltrate of one patient via PCR.

    Conclusions:

    • Insect bite-like reactions are uncommon, troublesome, and difficult to treat in patients with hematologic malignancies.
    • The reaction can occur before the hematologic disorder is diagnosed, necessitating careful evaluation.
    • Immunodeficiency is a potential factor in pathogenesis, but further research is needed to clarify the exact mechanisms and prognostic significance.