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February 2006

Tender Erythematous Plaques in a Woman With Acute Myelogenous Leukemia—Diagnosis

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

Microscopic examination showed a dense perivascular and interstitial infiltrate of neutrophils with leukocytoclasia. Rare lymphocytes and eosinophils were observed. There was no evidence of fibrinoid changes in the vasculature. Atypical changes suggestive of leukemia were not seen. The histologic changes were consistent with a diagnosis of SS.

The patient was treated with prednisone therapy, which was initiated at a dosage of 60 mg/d and tapered over 3 weeks, and 0.1% triamcinolone acetonide ointment; however, she required continued treatment with broad-spectrum antibiotics and G-CSF because of persistent fever and neutropenia. Her lesions resolved over the next 3 weeks, and she was subsequently treated with both cytarabine and G-CSF, without a recurrence of SS.

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