Chronic myelomonocytic leukemia can present with diffuse planar xanthoma

Area of Science:

• Dermatology
• Hematology
• Oncology

Background:

• Diffuse planar xanthoma is associated with chronic myelomonocytic leukemia (CMML).
• Previous reports suggested extensive cutaneous disease indicates reticuloendothelial system abnormalities.
• The link between solitary xanthoma lesions and hematologic disorders requires further investigation.

Observation:

• A 62-year-old woman presented with a large, pruritic, yellow-orange plaque on her chest and neck.
• The lesion was clinically consistent with planar xanthoma.
• Diagnostic workup revealed an underlying diagnosis of chronic myelomonocytic leukemia.

Findings:

• A solitary large plaque of planar xanthoma was identified.
• The patient was diagnosed with chronic myelomonocytic leukemia.
• This case challenges the notion that only diffuse disease signifies underlying hematologic issues.

Implications:

• Solitary planar xanthomas should be considered diagnostically equivalent to diffuse lesions.
• Prompt hematologic evaluation is crucial for patients presenting with large, solitary planar xanthomas.
• This finding expands the understanding of cutaneous manifestations of CMML.