Sterile suppurative folliculitis associated with acute myeloblastic leukaemia

A 20-year-old woman presented with a 4-month history of follicular papules distributed over the trunk and extremities. One month later, routine blood tests were abnormal, showing acute myeloblastic leukaemia (M1 in the French-American-British classification). Skin biopsy demonstrated a dermal infiltrate of a large number of neutrophils with occasional eosinophils and histiocytes in the vicinity of the hair follicle remnants. Intermingled in the infiltrate were atypical cells that were morphologically and immunohistochemically identical to leukaemic myeloblasts. Cultures of the papules and special stains of the biopsy specimen were negative for bacteria and fungi. The follicular eruption improved promptly in response to chemotherapy for the leukaemia. We suggest that this case may represent a rare, follicular variant of neutrophilic dermatosis associated with myelogenous leukaemia.