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Bullous leukemia cutis mimicking facial cellulitis

Luciana de Sales Caldato1, Juliana de Sousa Britto1, Ligia Niero-Melo1

  • 1Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.

Anais Brasileiros De Dermatologia
|May 19, 2016
PubMed

Insights

Bullous leukemia cutis, a rare skin manifestation of chronic lymphocytic leukemia, can mimic cellulitis. Prompt diagnosis and treatment with chemotherapy and immunotherapy led to complete remission.

Area of Science:

  • Hematology
  • Dermatology
  • Oncology

Background:

  • Bullous leukemia cutis is a rare cutaneous manifestation of leukemic cell infiltration.
  • It is an uncommon presentation of B-cell chronic lymphocytic leukemia (CLL).

Observation:

  • A 67-year-old female CLL patient on chlorambucil developed facial edema, erythema, and warmth, initially mistaken for cellulitis.
  • Subsequently, bullous lesions appeared on her extremities, neck, and face.

Findings:

  • Histopathology confirmed leukemia cutis in both facial and bullous lesions.
  • Lesions resolved completely after treatment with rituximab, fludarabine, and cyclophosphamide.

Implications:

  • Leukemia cutis can present as bullous lesions and mimic soft tissue infections like cellulitis.
  • This case highlights the importance of considering leukemia cutis in immunocompromised patients with atypical skin findings.
  • Effective treatment involves targeted immunochemotherapy for complete remission.

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