Leukemia cutis in T-cell acute lymphoblastic leukemia: a 3-year follow-up case report

Leukemia cutis (LC) is the infiltration of neoplastic leukocytes in the skin that can be observed in various types of leukemia including chronic lymphocytic leukemia, acute myeloid leukemia, and, occasionally, acute lymphoblastic leukemia. LC is considered an unfavorable prognostic factor in previous studies, and most patients die within 1 year after diagnosis. Herein, we report an uncommon case in which a patient presented with LC as the initial symptom of T-cell acute lymphoblastic leukemia (T-ALL) and remained in excellent clinical condition during a 3-year follow-up after treatment.

A 50-year-old Chinese woman manifested with multiple infiltrated purplish plaques and tumors over the face, trunk, and lower extremities for more than 5 months, accompanied by recurrent fever and arthralgia. The diagnosis of T-ALL with LC was established by skin biopsy and bone marrow examination. After treatment with chemotherapy and allogeneic stem cell transplantation, the patient achieved complete remission and remained in good health for 3 years. To our knowledge, this is the first described case of a favorable evolution after a 3-year follow-up.

Although uncommon, LC can be the first indication of the presence of T-ALL. This case highlights that early recognition of possible LC and access to treatment may benefit future patients with T-ALL and improve the prognosis of this aggressive disorder.