Extensive cutaneous manifestations: presenting feature of chronic myelocytic leukemia in second blast crisis

Abstract

Leukemia cutis is the infiltration of neoplastic leukocytes or their precursors into the epidermis, the dermis, or the subcutis, resulting in clinically identifiable cutaneous lesions. We describe a case of CML who presented with extensive cutaneous manifestations at the time of second blast crisis with multiple subcutaneous skin nodules over the face and trunk with extensive violaceous papules and plaques over all four limbs and the trunk, with scalp showing extensive crusting and scaling with foul smelling discharge.

Keywords: Blast crisis; CML; Leukemia cutis.

Figure 1

Multiple subcutaneous skin nodules seen over the face

Figure 2

Violaceous papules and plaques seen over the lower limbs

Figure 3

Extensive crusting and scaling seen over the scalp

Figure 4

Aspirate from skin nodule showing leukemic cells with lymphoblastoid morphology Giemsa ×40

Figure 5

Bone marrow showing extensive blast MGG (May-Grunwald Giemsa) 20×