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February 2006

Tender Erythematous Plaques in a Woman With Acute Myelogenous Leukemia—Quiz Case

Author Affiliations


Arch Dermatol. 2006;142(2):235-240. doi:10.1001/archderm.142.2.235-b

A 50-year-old hospitalized woman with newly diagnosed acute myelogenous leukemia suddenly developed tender, pruritic papules and plaques on her neck. She had been febrile during the preceding days (maximum temperature, 38.7°C). She was being treated by time-sequential chemotherapy with cytarabine (Ara-C) and etoposide (VP-16) and had received a dose of granulocyte colony-stimulating factor (G-CSF) 3 days earlier.

On physical examination, clusters of erythematous papules coalescing into indurated plaques with a pseudovesicular appearance were noted on the lateral and posterior aspects of her neck (Figure 1). Culture and direct fluorescent antibody tests were negative for herpes simplex and varicella zoster viruses. A 4-mm punch biopsy specimen of a lesion on the lateral aspect of the right side of the neck was stained with hematoxylin-eosin (Figure 2 and Figure 3).