Leukemia cutis (LC) is a localized or disseminated skin infiltration by leukemic cells. It is usually a sign of dissemination of systemic disease or relapse of existing leukemia.
Causes of Leukemia Cutis
Leukemia cutis is thought to result from a local proliferation of the leukemic cells within the skin.
Both a genetic component and an environmental component appear to be involved in many leukemias. A variety of well-characterized chromosomal translocations result in specific leukemic syndromes.
Patients with Down syndrome have an increased risk for both megakaryoblastic leukemia and pre–B-cell leukemia.
Diagnosis
Hematologic studies with complete analysis of bone marrow aspirate and peripheral blood smear and cutaneous histology and immunophenotyping are needed to make the diagnosis. If cutaneous findings precede any systemic disease, careful assessment of peripheral blood smears and bone marrow biopsies must be made.
Treatment
Therapy is usually directed at the leukemia itself. However, systemic chemotherapy sufficient for bone marrow remission may not treat the cutaneous lesions effectively. Thus, a combination of systemic chemotherapy and local electron-beam therapy or PUVA may be necessary for chemotherapy-resistant LC lesions.
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