Acne urticata associated with chronic myelogenous leukemia

Area of Science:

• Dermatology
• Hematology
• Oncology

Background:

• Acne urticata is an uncommon, intensely itchy papulopustular skin eruption.
• Diagnosis can be challenging due to non-specific skin biopsy findings.

Observation:

• A 56-year-old woman presented with a 6-month history of acne urticata.
• Skin lesion touch preparations revealed a significant eosinophil presence.
• Elevated serum histamine levels were noted.

Findings:

• Peripheral blood count, bone marrow examination, and Philadelphia chromosome positivity confirmed chronic myelogenous leukemia (CML).
• The patient's acne urticata resolved with hydroxyurea and antihistamine treatment.

Implications:

• This case highlights the importance of considering underlying hematologic malignancies in patients with unusual dermatologic presentations.
• Early diagnosis and management of CML can effectively treat associated cutaneous manifestations.
• Elevated histamine may play a role in the pathogenesis of CML-associated skin disease.