A cutaneous interstitial granulomatous dermatitis-like eruption arising in myelodysplasia with leukemic progression
Department of Pathology
Medical Subject Headings
Myelodysplastic Syndromes; Leukemia, Myeloid, Acute
Dermatology | Hemic and Lymphatic Diseases | Oncology | Pathology | Skin and Connective Tissue Diseases
Cutaneous manifestations associated with myelodysplastic syndromes (MDS) are uncommon and can occur as specific or nonspecific lesions. Recognizing these cutaneous manifestations is important as they can precede blood or bone marrow transformation to leukemia. Granulomatous reactions have rarely been described as nonspecific lesions of MDS. These rare cases histologically resembled granuloma annulare, sarcoid, and a generalized dermal interstitial granulomatous dermatitis (IGD) which were not associated with leukemic infiltration. The authors report an interesting case of an IGD-like eruption evolving over the course of MDS with eventual progression to systemic leukemia. IGD is an inflammatory reaction that refers to a varied spectrum of histologic patterns and is associated with a variety of systemic illnesses and hypersensitivity reactions, including lymphoma and leukemia. In patients with MDS, surveillance for leukemia is a critical component of their follow-up care. Normally, this surveillance occurs through serial peripheral blood smears and bone marrow studies. IGD-like eruptions are a cutaneous reaction pattern that may serve as an additional clinical indicator of leukemic progression in patients with MDS. Although primarily a reactive pattern, this entity can rarely harbor leukemic blasts.
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Citation: Am J Dermatopathol. 2013 Apr;35(2):e26-9. doi: 10.1097/DAD.0b013e31826ff6a6. Link to article on publisher's site
Cornejo, Kristine M.; Lum, Christopher A.; and Izumi, Allan K., "A cutaneous interstitial granulomatous dermatitis-like eruption arising in myelodysplasia with leukemic progression" (2013). University of Massachusetts Medical School Faculty Publications. 103.