Subject(s)
Eosinophilia/diagnosis , Fasciitis/diagnosis , Adult , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging , Thigh/pathologySubject(s)
Dermatology/instrumentation , Surgical Instruments , Equipment Design , Humans , SyringesABSTRACT
BACKGROUND: Chronic lymphocytic leukaemia (CLL) is a malignancy characterized by clonal expansion of B lymphocytes with distinct morphology and immunophenotype. The dermatological literature relating to CLL is sparse. A global descriptive survey of a large number of CLL patients has not previously been published. OBJECTIVES: To report the spectrum of dermatological conditions seen in a large series of CLL patients. METHODS: Skin complications in patients with established CLL were identified retrospectively from clinical and photographic records, principally a database of over 750 consecutive cases. These events were classified, enumerated and compared. RESULTS: Forty patients with 125 skin manifestations were identified and studied. Forty-one manifestations had documented clinical or histological atypia. In 21 of these 41 complications there had been no prior immunosuppressive therapy. We observed that cutaneous malignancies frequently presented atypically both clinically and histologically. There were 18 patients with 56 instances of basal cell carcinoma (BCC) or squamous cell carcinoma (SCC), and clinical atypia was more common with SCC than with BCC. Other cutaneous findings included varicella zoster (n = 6), leukaemia cutis (n = 3), acute graft-versus-host disease (n = 5), cutaneous drug eruptions (n = 9), multiple warts (n = 3), herpes simplex (n = 3), cutaneous T-cell lymphoma (n = 2), eosinophilic folliculitis (n = 2), malignant melanoma (n = 2) and Merkel cell tumour (n = 2). CONCLUSIONS: We have identified a range of dermatological conditions in CLL patients, with a tendency to atypical presentations. The atypia was independent of prior chemotherapy.
Subject(s)
Leukemia, Lymphocytic, Chronic, B-Cell/pathology , Skin Diseases/pathology , Acute Disease , Adult , Aged , Carcinoma, Basal Cell/complications , Carcinoma, Merkel Cell/complications , Carcinoma, Squamous Cell/complications , Chickenpox/complications , Drug Eruptions/complications , Female , Folliculitis/complications , Graft vs Host Disease , Herpes Simplex/complications , Humans , Lymphoma, T-Cell, Cutaneous/complications , Male , Melanoma/complications , Middle Aged , Retrospective Studies , Skin Neoplasms/complications , Warts/complicationsSubject(s)
Acitretin/therapeutic use , Alcoholism/complications , Carcinoma, Squamous Cell/etiology , Cyclosporine/therapeutic use , Immunosuppressive Agents/therapeutic use , Keratolytic Agents/therapeutic use , Psoriasis/complications , Skin Neoplasms/etiology , Ultraviolet Rays/adverse effects , Cyclosporine/adverse effects , Humans , Immunosuppressive Agents/adverse effects , Leg , Male , Middle Aged , PUVA TherapyABSTRACT
A 49-year-old man presented with a reproducible, localized amoxycillin-clavulanic acid-induced eruption. The histopathology from lesional skin revealed a neutrophilic dermatosis. These histological findings have not been reported in previous fixed drug eruptions. A brief review is undertaken comparing fixed drug eruption and the group of neutrophilic dermatoses with our case presentation. We propose a new entity of neutrophilic fixed drug eruption.
