[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.157.19.94. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Citations 0
Off-Center Fold
September 2010

Skin Nodules in a Patient With Acute Myeloid Leukemia and Neurological Deterioration—Quiz Case

Author Affiliations
 

MARY S.STONEMDSOONBAHRAMIMDCARRIE ANN R.CUSACKMDSENAIT W.DYSONMDMOLLY A.HINSHAWMDVINCENTLIUMD

Arch Dermatol. 2010;146(9):1037-1042. doi:10.1001/archdermatol.2010.216-a

A 57-year-old man was admitted for reinduction chemotherapy for relapse of acute myeloid leukemia. Two weeks into his hospitalization, he developed low-grade fevers and right orbital edema and was thought to have scleritis or keratouveitis. Within 24 hours, he also developed neurologic symptoms, including left hemiparesis. A brain magnetic resonance image that was obtained to evaluate his neurologic symptoms and orbital edema revealed multiple acute and subacute infarcts for which emboli were a concern. A transthoracic echocardiogram was negative for vegetations. On skin examination, he was noted to have a few 1- to 2-cm tender, violaceous, round papules and plaques, some with dark, necrotic centers, on the right cheek and lower extremities (Figure 1). Two biopsyspecimens were obtained from a lesion on the right knee and sent for routine histopathologic analysis (Figure 2) and periodic acid–Schiff staining (Figure 3). Bacterial, mycobacterial, and fungal cultures were also performed.

First Page Preview View Large
First page PDF preview
First page PDF preview
×