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JAMA Oncology Clinical Challenge
December 30, 2020

Red Plaques in a Pediatric Patient With Acute Leukemia of Ambiguous Lineage

Author Affiliations
  • 1Women’s and Children’s Hospital, North Adelaide, Adelaide, South Australia, Australia
  • 2SA Pathology, Women’s and Children’s Hospital, North Adelaide, Adelaide, South Australia, Australia
JAMA Oncol. 2021;7(3):454-455. doi:10.1001/jamaoncol.2020.6134

A 16-year-old boy with acute leukemia of ambiguous lineage developed tender, 1- to 2-cm erythematous plaques and nodules during treatment with chemotherapy. Previously, he had been well, with morphological remission found on a recent bone marrow biopsy. The patient had no significant dermatological history, except an allergy to cashew nuts and a prior episode (6 mo) of urticaria during a platelet transfusion that had resolved with 1 dose of oral antihistamine. The patient’s medications included ondansetron, aprepitant, prednisolone, and oxycodone (supportive care initiated with chemotherapy), and long-term posaconazole and trimethoprim/sulfamethoxazole treatment.

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