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Myelogenous Leukemia. Presented by Dr. Orlando Canizares and Dr. Maurice J. Costello.
A. R. P., a girl aged 14, was operated upon in February, 1953, for acute appendicitis. Her postoperative course was uneventful for eight days, at which point she developed an erythematous eruption on the forehead, left arm, and left side of the chin, associated with fever and chills. The diagnosis of penicillin reaction was considered, but because the lesions were like erythema nodosum and the patient had joint pains, the diagnosis of rheumatic fever was made. Treatment with salicylates and corticotropin (ACTH) was instituted, and the symptoms improved. There were three recurrences, each with extensive cellulitis-like lesions, some covered with large bullae, and each time treatment with corticotropin and cortisone led to complete remission. The laboratory tests were normal except for severe anemia and on one occasion an increase of the white blood cell count. A biopsy