[Skip to Navigation]
Views 2,573
Citations 0
JAMA Dermatology Clinicopathological Challenge
October 28, 2020

Generalized Pruriginous Eruption on a Patient With Leukemia

Author Affiliations
  • 1Dermatology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
JAMA Dermatol. 2020;156(12):1369-1370. doi:10.1001/jamadermatol.2020.3999

A woman in her 50s with a recent diagnosis of acute myeloid leukemia (subtype M5a, French-American-British classification) was admitted to the hospital for induction chemotherapy. At presentation she had a 3-week history of a striking pruritic and generalized cutaneous eruption. The patient otherwise felt well and denied fever, malaise, insect bites, or starting new drug treatments. Except for leukopenia and a slightly elevated C-reactive protein level, results of other routine blood and urine tests were unremarkable. Physical examination revealed an erythematous eruption composed of small indurated and edematous papules (Figure, A and B). Confluent papules leading to large urticariform plaques, some with annular configuration, were present on the flanks, lower legs, breasts, and scalp. Hyperpigmented patches and focal areas of bruiselike discoloration were seen adjacent to acute lesions. Mucous membranes, palms, and soles were spared. A biopsy specimen was obtained (Figure, C and D).

Add or change institution
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words