Leukaemia Cutis: Clinical Features and Outcomes of 56 Patients

Abstract

Leukaemia is a malignant neoplasm of the haematopoietic system. Cutaneous manifestations of leukaemia are called leukaemia cutis, and are regarded as a sign of poorer prognosis and shorter survival time. A single-institution retrospective review was performed of medical records of patients diagnosed with leukaemia cutis in the dermatology department of Seoul St Mary's Hospital between January 2012 and April 2021. Fifty-six cases with cutaneous leukaemic involvement and underlying haematological malignancy were included (40 acute myelogenous leukaemia, 8 acute lymphoblastic leukaemia, 3 chronic myeloid leukaemia, 2 chronic lymphocytic leukaemia, and 3 myelodysplastic syndrome). Male-female ratio 1.9:1, mean age at diagnosis 45.8 years. Plaques (28%) and papules (27%) were the most common skin lesions, followed by patches (18%) and nodules (16%). Mean time from diagnosis of leukaemia to development of leukaemia cutis was 12.3 months. Forty-six patients (84%) died during the 7-year follow-up; mean time from diagnosis of leukaemia cutis to death was 5.4 months. The results suggest that leukaemia cutis is associated with poor outcomes in patients with leukaemia. Comprehensive skin examination of these patients may help diagnose leukaemia cutis early, enabling prompt treatment.

Fig. 1

Clinical appearance of leukaemia cutis (LC). (A) Multiple macules on the abdomen of an acute myelogenous leukaemia (AML) patient. (B) Large patch and satellite macules on the abdomen of an AML patient. (C) Multiple papules on the right arm of an AML patient. (D) Variable-sized plaques on the abdomen of an AML patient. (E) Solitary nodule on the flank area of an AML patient. (F) Ulcer and crust on the nose of a myelodysplastic syndrome patient. (G) Firm nodule on the right lower leg of an AML patient.

Fig. 2

Gross skin lesions of paediatric leukaemia cutis (LC) patients. (A) Scattered, erythematous papules on the leg of a 1-year-old boy with acute lymphoblastic leukaemia (ALL). (B, C) Numerous patches and papules on the extremities of an 18-year-old boy with acute myelogenous leukaemia (AML). (D, E) Purpuric patch and papules on a 14-year-old boy with ALL. (F) Solitary firm nodule on the upper back of a 15-year-old boy with AML.

Fig. 3

Bar graph of the clinical features of leukaemia cutis (LC) according to the type of leukaemia. AML: acute myelogenous leukaemia; ALL: acute lymphoblastic leukaemia; CML: chronic myeloid leukaemia; CLL: chronic lymphocytic leukaemia; MDS: myelodysplastic syndrome.

Fig. 4

Bar graph of the clinical distribution of leukaemia cutis (LC) according to the type of leukaemia. AML: acute myelogenous leukaemia; ALL: acute lymphoblastic leukaemia; CML: chronic myeloid leukaemia; CLL: chronic lymphocytic leukaemia; MDS: myelodysplastic syndrome.