A Case of Leukemia Cutis in a Patient with Primary Myelofibrosis / 대한피부과학회지

Primary myelofibrosis (PMF) is a chronic myeloproliferative disorder that is characterized by clonal proliferation of myeloid cells in the bone marrow. PMF should be distinguished from other chronic myeloproliferative neoplasms. Leukemia cutis is defined as cutaneous infiltration of malignant hematopoietic cells. The clinical features of leukemia cutis are variable, and the lesions may be localized or disseminated. A 53-year-old male individual presented with a month's history of several erythematous papules on the trunk. The number of lesions had increased, but he had no subjective symptom. He was diagnosed with PMF 3 years ago. For the last 5 months, he has suffered from inguinal lymph node enlargement, myalgia, and abdominal discomfort. Laboratory test showed leukocytosis in the peripheral blood (blast cells: 18%). Histopathologic examination of skin lesions showed perivascular infiltration of immature myeloid cells in the dermis. The infiltrative cells showed positivity for myeloperoxidase. We diagnosed the condition as leukemia cutis from primary myelofibrosis.

Unusual Cutaneous Neutrophilic Infiltration in Myelodysplasia Syndrome : A Nuclear Segmentation Anomaly

We report a case of myelodysplastic syndrome (MDS) with unique histopathological findings in which numerous infiltrated neutrophils exhibited nuclear segmentation anomalies. In comparison with well-described neutrophilic dermatoses of myelodysplastic syndrome such as Sweets syndrome and pyoderma gangrenosum, this case took a rapid and aggressive clinical course. We suggest that a nuclear segmentation anomaly, pseudo Pelger-Hiiet anomaly, is likely to reflect acute transformation of MDS and can be a poor prognostic marker.