Leukemia Cutis

Leukemia cutis characteristically demonstrates the infiltration of the skin by neoplastic leukocytes. While the extramedullary collection of leukemic cells is generally regarded as myeloid sarcoma (previously chloroma/granulocytic sarcoma), leukemia cutis is a generic term to describe specific cutaneous involvement. Although any subtype of leukemia can involve the skin, the most common types seen in clinical practice are chronic lymphocytic leukemia (CLL) and acute myeloid leukemia (AML) with monocytic or myelomonocytic morphology. Involvement by chronic myeloid leukemia (CML) is extremely rare and may be indicative of the blast phase. Patients usually have a prior diagnosis of systemic leukemia or myelodysplasia. However, cutaneous lesions may present as the primary manifestation of systemic disease in rare cases. Cutaneous involvement is generally indicative of advanced disease and should stipulate the investigation of other body sites for extramedullary involvement.

Subtypes of Leukemia Involving Skin:

Myeloid/monocytic disorders:

1. Acute myeloid leukemia (monocytic or myelomonocytic) (AML)

2. Chronic myeloid leukemia

3. Chronic myelomonocytic leukemia (transformation)

4. Myelodysplastic syndrome (transformation)

Lymphoproliferative disorders:

1. B- cell leukemia/lymphomas

   1. Precursor B-cell acute lymphoblastic leukemia

   2. Chronic lymphocytic leukemia (CLL)

   3. Hairy cell leukemia

1. T- cell leukemia/lymphomas

   1. Precursor T-cell acute lymphoblastic leukemia

   2. Adult T-cell leukemia/lymphoma (ATLL)

   3. T- cell prolymphocytic leukemia