Cutaneous leukaemic infiltrations in a patient with previously undiagnosed myelodysplastic syndrome


K. Scharffetter-Kochanek, Department of Dermatology and Allergology, University of Ulm, Maienweg 12, D-89081 Ulm, Germany. Tel.: +49 731 500 21801. Fax: +49 731 500 21870.


We report the rare case of a patient with leukaemia cutis first presenting only on the hand and fingers and then subsequently spreading over the trunk and face. The lesions heralded the transformation of a previously undiagnosed myelodysplastic syndrome type RAEB (refractory anaemia with blast excess) into frank myeloid leukaemia. The haematological disease was first detected by the dermatohistopathologist. This case underlines the need to look meticulously for skin changes and perform early skin biopsies in haematological patients, as the skin can reveal the first clinical signs of an otherwise not evident bone marrow disorder. Leukaemia cutis as the initial clinical presentation of a transforming myelodysplastic syndrome type RAEB into acute myeloid leukaemia has been reported only very rarely.