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Teenager with persistent facial edema and induration
Mónica Dávalos-Tanaka1, Ma Teresa García-Romero1
1Department of Dermatology, Instituto Nacional de Pediatría, Mexico City, Mexico.
Boletin Medico Del Hospital Infantil De Mexico
|October 8, 2024
Summary
Skin infiltration in pediatric acute lymphoblastic leukemia (ALL) is rare, often appearing after diagnosis. This case highlights leukemia cutis in a teen with pre-B ALL, emphasizing biopsy for diagnosis and chemotherapy for treatment.
Area of Science:
- Pediatric Oncology
- Dermatology
- Hematology
Background:
- Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer.
- Skin infiltration (leukemia cutis) is rare in ALL, occurring in 1-3% of cases, typically post-diagnosis.
Observation:
- A teenage male presented with facial edema, indurated plaques, and systemic symptoms (asthenia, adynamia).
- Physical exam revealed facial edema, indurated plaques, and widespread adenopathy.
- Pancytopenia and a mediastinal mass were noted on initial workup.
Findings:
- Bone marrow and skin biopsies confirmed pre-B ALL with leukemia cutis.
- The patient responded to chemotherapy and is currently in the maintenance phase.
Implications:
- Leukemia cutis presents heterogeneously and is uncommon in pediatric pre-B ALL.
- Diagnosis requires biopsy; treatment involves systemic chemotherapy.
- Consider leukemia cutis in pediatric patients with unexplained edematous or indurated skin lesions and systemic symptoms.
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