A Cutaneous Interstitial Granulomatous Dermatitis-Like Eruption Arising in Myelodysplasia With Leukemic Progression
A Cutaneous Interstitial Granulomatous Dermatitis-Like Eruption Arising in Myelodysplasia With Leukemic Progression
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DOI：
10.1097/dad.0b013e31826ff6a6
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发表时间：
2013-04-01
影响因子：
1.1
通讯作者：
Izumi, Allan K.
中科院分区：
文献类型：
--
作者：
Cornejo, Kristine M.;Lum, Christopher A.;Izumi, Allan K.
与骨髓增生异常综合征 (MDS) 相关的皮肤表现并不常见，可能以特异性或非特异性病变的形式出现。认识这些皮肤表现很重要，因为它们可能先于血液或骨髓转化为白血病。肉芽肿反应很少被描述为MDS的非特异性病变。这些罕见病例的组织学类似于环状肉芽肿、结节病和全身性真皮间质性肉芽肿性皮炎（IGD），与白血病浸润无关。作者报告了一个有趣的病例，即在 MDS 病程中出现类似 IGD 的皮疹，最终进展为系统性白血病。 IGD 是一种炎症反应，涉及多种组织学模式，与多种全身性疾病和超敏反应相关，包括淋巴瘤和白血病。对于 MDS 患者，白血病监测是其后续护理的重要组成部分。通常，这种监测是通过一系列外周血涂片和骨髓研究进行的。 IGD 样皮疹是一种皮肤反应模式，可作为 MDS 患者白血病进展的额外临床指标。虽然主要是一种反应性模式，但该实体很少含有白血病细胞。
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.