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Chilblain-like leukemia cutis.

Andrew G Affleck1, Jane C Ravenscroft, Iain H Leach

  • 1Department of Dermatology, Queen's Medical Centre, University Hospital Nottingham NHS Trust, Nottingham, UK. andyaffleck@doctors.org.uk

Pediatric Dermatology
|February 16, 2007
PubMed
Summary
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A child presented with chilblain-like lesions, leading to the diagnosis of juvenile myelomonocytic leukemia. This rare leukemia was confirmed through bone marrow analysis and cell marker identification.

Area of Science:

  • Pediatric Hematology
  • Dermatology
  • Oncology

Background:

  • Chilblain-like lesions can be a rare presenting symptom in pediatric hematologic malignancies.
  • Early identification of subtle hematologic abnormalities is crucial for timely diagnosis.

Purpose of the Study:

  • To report a case of juvenile myelomonocytic leukemia presenting with unusual skin manifestations.
  • To highlight the diagnostic process involving skin biopsy and bone marrow examination.

Main Methods:

  • Clinical presentation of fluctuating chilblain-like lesions over 8 months.
  • Hematological analysis including full blood count, skin biopsy with immunocytochemistry (CD3, CD43, lysosyme), and bone marrow biopsy.
  • Assessment of spontaneous marrow colony growth in culture.

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Main Results:

  • Skin biopsy revealed a dermal infiltrate of monocytic origin (CD3(-), CD43(+), lysosyme +).
  • Blood count showed mild thrombocytopenia and monocytosis.
  • Bone marrow examination confirmed the diagnosis of juvenile myelomonocytic leukemia.

Conclusions:

  • Juvenile myelomonocytic leukemia can manifest with cutaneous symptoms mimicking chilblains.
  • Immunocytochemistry and bone marrow studies are essential for diagnosing this rare pediatric malignancy.