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December 1978

Bullous Pyoderma Gangrenosum and Acute Leukemia

Author Affiliations

From the Division of Dermatology, Department of Medicine, University of Toronto.

Arch Dermatol. 1978;114(12):1842-1843. doi:10.1001/archderm.1978.01640240072021

There have been several reports of bullous pyoderma gangrenosum occurring in association with acute myeloid leukemia.1-4

We report on a patient who had two episodes of bullous pyoderma gangrenosum; the first episode occurred several months before evidence of leukemia appeared. A skin biopsy specimen obtained early in the second episode showed unique changes.

Report of a Case  A 33-year-old woman was admitted in October of 1975 with anemia, general malaise, and pyrexia. Her temperature was 40 °C, but examination results were unremarkable. Shortly after admission, tender fluctuant nodules, with superficial pustule formation, developed on her left hip and left upper arm. During the next five to seven days these became large necrotic bullous lesions, which rapidly ulcerated. Bullous pyoderma gangrenosum, associated with acute leukemia, was suspected, but a bone marrow specimen showed no definite evidence of leukemia. Abnormal investigation results were as follows: hemoglobin level, 8.6 g/dl; and WBC