Leukemia cutis

QUESTION 58

A 68-year-old man presents to his general practitioner with a 9-month history of progressive fatigue, nausea and rash. He has noticed increased fatigue with minimal exertion, which has prevented him from performing his usual activities. He also states that he initially noticed red bumps on his shoulders, which are asymptomatic but continue to spread across his chest and back. On examination, there are scattered erythematous to violaceous papules and nodules, some coalescing into plaques distributed over the chest, back, arms and face (58a, b). Laboratory studies reveal a marked lymphocytosis (white blood cells [WBC] 46 × 10⁹/L) and a peripheral smear is composed of >25% blasts and ‘smudge’ cells.

Only gold members can continue reading. Log In or Register to continue