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Eosinophilic dermatosis in a patient with chronic lymphocytic leukemia: a rare case report
Angeliki Gardikioti1, Theodora Maria Venou1, Maria Mainou1
1Hematological Laboratory, Second Department of Internal Medicine, Aristotle University, Hippokration Hospital, Thessaloniki, Greece.
Insights
This case study details a rare instance of eosinophilic dermatosis of hematologic malignancy (EDHM) in a patient with chronic lymphocytic leukemia (CLL). It highlights the importance of recognizing diverse skin manifestations in CLL patients.
Area of Science:
- Hematology
- Dermatology
- Oncology
Background:
- Chronic lymphocytic leukemia (CLL) is a B-cell malignancy. Patients can develop various skin conditions, including specific (leukemic infiltration) and non-specific lesions.
- Non-specific skin eruptions are common in CLL and include conditions like vasculitis and eosinophilic dermatosis.
- Eosinophilic dermatosis of hematologic malignancy (EDHM) is a rare, pruritic, papular, and sometimes vesicular rash associated with blood cancers.
Observation:
- A 58-year-old woman with a history of B-cell CLL presented with a diffuse, vesicular, and pruritic rash.
- The patient had previously undergone immuno-chemotherapy for her CLL.
- The presentation was consistent with EDHM, a rare cutaneous manifestation.
Findings:
- The case highlights a rare presentation of EDHM in a patient with B-cell CLL.
- The patient's skin eruption was characterized as a diffuse vesicular pruritic rash.
- A review of existing literature on EDHM in CLL patients was conducted.
Implications:
- Recognizing rare cutaneous manifestations like EDHM is crucial for managing patients with CLL.
- This case underscores the diverse dermatological presentations associated with hematologic malignancies.
- Further research into the mechanisms and management of EDHM in CLL is warranted.
Abstract:
Chronic lymphocytic leukemia (CLL) is a type of malignant lymphoproliferative disorder characterized by a rapid and uncontrolled increase in lymphoid cells, mostly monoclonal B-cells (B-CLL). Patients with CLL may present cutaneous lesions that can be classified as either "specific" or "non-specific." In CLL patients, specific skin eruptions arise from leukemic cell infiltration, recognized histopathologically in tissue sample biopsy. Non-specific lesions encompass the majority of eruptions in CLL patients and may present as petechiae, purpura, urticaria, exfoliative dermatitis, paraneoplastic pemphigus, vasculitis, or eosinophilic dermatosis. Eosinophilic dermatosis of hematologic malignancy (EDHM) is a rare cutaneous manifestation that presents as an eruption in various locations and is characterized as papular, pruritic, and sometimes vesicular or vesiculobullous. Here we present a rare and interesting case of a 58-year-old woman with a medical history of B-CLL that was examined at our clinic for evaluation of an unspecified diffuse vesicular pruritic rash. The patient was first diagnosed with CLL 3 years earlier and followed a 6-month course of immuno-chemotherapy with rituximab, fludarabine, and cyclophosphamide. We also performed brief review of previous literature and present the results.
