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December 1983

Leukocytoclastic Vasculitis in Hairy Cell Leukemia (Leukemic Reticuloendotheliosis)

Author Affiliations

From the Departments of Dermatology (Dr Kenny) and Pathology (Drs Shum and Smout), University of Western Ontario, London, Ontario.

Arch Dermatol. 1983;119(12):1018-1019. doi:10.1001/archderm.1983.01650360064015

The incidence of skin lesions in hairy cell leukemia is low. In a series of 71 cases, ten patients had cutaneous lesions of an unspecified type and only one patient had a diagnostic infiltration of hairy cells found in the skin biopsy specimen.1 Recently, polyarteritis nodosa with nodular panniculitis2 and necrotic skin lesions on the legs with acute neutrophilic vasculitis3 have been reported in association with hairy cell leukemia.

We describe a patient with hairy cell leukemia who had widespread papules and plaques with pustules. Histopathologically, these lesions showed an acute leukocytoclastic vasculitis.

Report of a Case  In 1978, hairy cell leukemia (leukemic reticuloendotheliosis) was diagnosed in a 46-year-old man. This diagnosis was based on the finding of tartrate-resistant-acid-phosphatase-positive-staining hair cells in peripheral blood smears. He had had a therapeutic splenectomy in 1978. The spleen showed mononuclear cell infiltrates characteristic of leukemic reticuloendotheliosis on histologic examination. A

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