Leukemia Cutis Associated with Secondary Plasma Cell Leukemia

Area of Science:

• Hematology
• Dermatology
• Oncology

Background:

• Plasma cell leukemia is an aggressive hematologic malignancy.
• Leukemia cutis signifies skin infiltration by malignant leukocytes.
• Plasma cell leukemia cutis is a rare, severe presentation.

Observation:

• A patient with multiple myeloma developed plasma cell leukemia cutis post-stem cell transplant.
• Cutaneous nodules appeared on limbs 50 days after transplant.
• Histopathology revealed CD138-positive atypical plasma cells with kappa restriction.

Findings:

• The patient's skin lesions mirrored the myeloma's phenotype.
• Despite treatment, the patient died 25 days after skin lesion onset.
• Leukemia cutis in plasma cell leukemia is infrequent but carries a grave prognosis.

Implications:

• New skin lesions in plasma cell leukemia warrant biopsy for cancer or infection evaluation.
• Prompt diagnosis of plasma cell leukemia cutis is critical.
• This presentation is associated with extremely poor outcomes, highlighting the need for aggressive management strategies.