Acute Myeloid Leukemia Involving the Skin

Leukemia cutis (LC) refers to cutaneous infiltration by leukemic cells, most often by acute myeloid leukemia (AML) in adults and by lymphoblastic leukemia in children. Although uncommon, LC is a clinically significant manifestation of extramedullary disease and may precede, coincide with, or follow bone marrow involvement. Recognition of AML-associated LC is essential, as it can be diagnostically challenging due to histopathologic overlap with inflammatory dermatoses and other cutaneous hematolymphoid neoplasms. Recent cohort-based studies have systematically characterized AML involving the skin, demonstrating frequent immunophenotypic discordance between cutaneous and marrow blasts and recurrent genetic associations, with important diagnostic and prognostic implications for dermatopathologists. This review provides a practical framework for current and historical nomenclature, the diagnosis of cutaneous AML, and key histopathologic patterns and pitfalls.