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Isolated leukemia cutis--a case report.

A Haubenstock, R Zalusky, V S Ghali

    American Journal of Hematology
    |April 1, 1987
    PubMed
    Summary
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    This case study highlights a patient with acute myelomonocytic leukemia whose skin lesions (leukemia cutis) reappeared during remission. 6-thioguanine effectively treated these recurrent skin manifestations, suggesting its role in managing extramedullary leukemia.

    Area of Science:

    • Hematology
    • Dermatology
    • Oncology

    Background:

    • Acute myelomonocytic leukemia (AMML) is a rare hematologic malignancy.
    • Leukemia cutis, or skin infiltration by leukemia cells, can be an early or late manifestation.
    • Extramedullary disease can occur even during hematologic remission.

    Observation:

    • A 67-year-old woman presented with leukemia cutis preceding bone marrow involvement in AMML.
    • Skin lesions recurred despite hematologic remission achieved through induction chemotherapy.
    • The patient's blood and bone marrow remained in remission while skin lesions reappeared.

    Findings:

    • Induction chemotherapy initially cleared both bone marrow and skin manifestations.
    • 6-thioguanine, as part of maintenance therapy, led to the resolution of recurrent leukemia cutis.

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  • This suggests a potential role for 6-thioguanine in managing extramedullary leukemia recurrence.

    • Implications:

    • Leukemia cutis can manifest and recur independently of bone marrow status in AMML.
    • Targeted therapy, such as 6-thioguanine, may be effective for managing refractory or relapsed extramedullary leukemia.
    • This case underscores the importance of monitoring for extramedullary disease, even during hematologic remission.