Clinicopathologic spectrum of cutaneous diseases in patients with hematologic malignancies with or without allogeneic bone marrow transplantation: an observational cohort study in 101 patients

G Ital Dermatol Venereol. 2013 Oct;148(5):453-63.

Abstract

Aim: Objective of the study was to determine the most common cutaneous lesions in patients with haematologic malignancies observed at dermatologic consultation and to identify the impact parameters related to the haematologic condition, like disease type/duration, remission, chemotherapy and transplantation, have on skin manifestations.

Methods: A total of 101 consecutive patients with onco-haematological malignancies referred for dermatological consultation over a two-year period were included in this prospective single-centre observational cohort study.

Results: The most common finding was infection (19.8%), followed by drug adverse reactions (16.8%) and malignant neoplasia (11.9%). Elderly patients and those with a longer disease duration had a higher frequency of cutaneous neoplasia. Squamous cell carcinoma was the most frequent cutaneous neoplasia; three cases of melanoma were diagnosed and had a high Breslow thickness. Cutaneous involvement due to the haematological malignancies was observed in 5 patients. Common chronic dermatoses (psoriasis and eczema) were found in 10% of patients. Transplant had no effect on the percentage of infections or tumours.

Conclusion: Patients with haematological malignancies have a higher incidence of adverse drug reactions with peculiar morphologic features and a lower incidence of common chronic dermatoses than patients referred for dermatological consultation by their general practitioner or other hospital services. Infectious dermatoses were less frequent than in solid organ transplanted patients. The complex variety of cutaneous lesions, the differential diagnostic pitfalls and the prognostic relevance of early skin tumour diagnosis, evidence the importance of a correct dermatological approach.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Allografts
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Bone Marrow Transplantation*
  • Carcinoma, Squamous Cell / epidemiology
  • Cohort Studies
  • Combined Modality Therapy
  • Comorbidity
  • Drug Eruptions / epidemiology
  • Female
  • Graft vs Host Disease / epidemiology
  • Hematologic Neoplasms / drug therapy
  • Hematologic Neoplasms / epidemiology*
  • Hematologic Neoplasms / surgery*
  • Humans
  • Immunocompromised Host
  • Male
  • Middle Aged
  • Neoplasms, Multiple Primary / epidemiology
  • Neoplasms, Second Primary / epidemiology
  • Prospective Studies
  • Psoriasis / epidemiology
  • Referral and Consultation
  • Skin Diseases / epidemiology*
  • Skin Diseases, Infectious / epidemiology
  • Skin Neoplasms / epidemiology
  • Young Adult

Substances

  • Antineoplastic Agents