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).
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Núñez-Hipólito L, Moya-Martínez C, Requena L. Generalized Pruriginous Eruption on a Patient With Leukemia. JAMA Dermatol. 2020;156(12):1369–1370. doi:10.1001/jamadermatol.2020.3999
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