Leukemia skin (skin leukemia)

Skin leukemids (synonyms: skin leukemia, hemoderma) are symptoms of leukemia and manifest in its terminal stage. However, sometimes skin signs are the initial symptoms of leukemia, when other symptoms (changes in blood, lymph nodes and bone marrow) are still absent.

[1], [2], [3], [4], [5], [6], [7], [8]

Causes and pathogenesis of skin leukemids

Until now, the nature of leukemia remains unknown. According to most scientists, leukemia is based on a tumor process in the hematopoietic tissue controlled by a particular gene.

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Symptoms of skin leukemia

Skin rashes in leukemia are divided into specific and nonspecific. Nonspecific are devoid of characteristic morphological features and can be caused by concomitant processes and complications (anemia, thrombocytopaedy, sepsis). In the latter case, sometimes long before the appearance of clinical signs of damage to the hematopoietic system, skin pruriginous, bullous, erythematous-squamous eruptions resembling pemphigus, erythema multiforme, eczema, lupus erythematosus, etc., appear. Skin rashes intensify during the exacerbation of the underlying disease. In the terminal stage of leukemia, multiple hemorrhages, septic necrosis of the skin are often noted.

Specific changes in skin leukemia are diverse, often occur in the form of papular, nodular and tumor-like formations and erythrodermia

The most common are numerous papular, less often spotted-papular elements, which are more characteristic of myeloblastic leukemia. Nodules of various sizes (from millet grains to peas) have rounded outlines, a hemispherical or flat shape, a dense, less often soft consistency, a cyanotic red color, often with a yellowish-brown tinge. The surface of the papules is smooth, sometimes it can be covered with telangiectasias, scales, or leaflike crusts. Elements are often arranged symmetrically and can occur in any areas, including the mucous membranes of the mouth. As a rule, they appear suddenly and are located symmetrically in different parts of the skin. Subjective sensations in the papular version is usually not noted, sometimes patients complain of itching of the skin.

Nodular leukemides have a cyanotic pink or brownish-brown color, a smooth surface on which hemorrhagic eruptions, telangiectasias, layered crusts and milium-like papules that result from blockage of enlarged hair follicles are sometimes determined. They are slowly progressing. From the subjective sensations, pain is noted with pressure, there is no itching of the skin. Spontaneous regression of individual knots is possible.

With acute leukemia, the color of the elements becomes saturated red, blisters, ulcers, petechial rashes, mucous membranes are affected. Tumor leukemia occurs as a result of the fusion of several individual knots, penetrate deeply into the hypodermis, have large dimensions, a dense consistency (sometimes woody). Often there is a combination of several specific rashes with nonspecific lesions of the skin.

Occasionally, specific erythroderma may develop, which is common in chronic lymphocytic leukemia, monoblastic leukemia, and less often in other leukemia variants. For such erythroderma is characterized by the presence of intense itching, it is clinically difficult to distinguish it from erythrodermia of another nature.

With skin leukemias, diffuse infiltrations and primary ulcers may occur. As a result of thickening of the skin, the formation of deep and superficial furrows on its surface, diffuse infiltrations arise that occupy vast areas of the skin.

Primary ulcers with hemoderms of round or oval shape reach significant dimensions (5-10 cm and more in diameter), have a brilliant juicy bottom of a rich red color. The bottom of ulcers in places is often covered with granulations, purulent-necrotic plaque and bloody crusts. Ulcers have uneven, undercut, infiltrated margins.