Cutaneous leukocytoclastic vasculitis complicating hairy cell leukemia (leukemic reticuloendotheliosis)

A patient with hairy cell leukemia (HCL) receiving fluoxymesterone developed cutaneous leukocytoclastic vasculitis. His clinical picture was of purpuric papules and pustules on his chest and limbs. Oral corticosteroid therapy and colchicine therapy were tried, with only minimal improvement. Chemotherapy with pentostatin (2'-deoxycoformycin) resolved the vasculitis and placed the HCL in remission. Fifteen cases of HCL associated with vasculitis have been reported previously. Hairy cell leukemia and vasculitis appear to have more than a coincidental relationship.