Skin lesions in B-cell chronic lymphocytic leukemia
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文摘
The frequency of cutaneous lesions arising during the course of chronic lymphocytic leukemia (CLL) varies from 4 to 44.6 % , depending on the different selective criteria. The aim of this study was to control the frequency and the clinical relevance of cutaneous lesions in a group of patients affected by B-cell CLL. One hundred patients out of 800 subjects affected by B-CLL, observed from 1986 to 1994, underwent careful haemathological and cutaneous examination. If necessary skin biopsies were taken. Ten patients were affected by crythemato-papulo-nodular lesions, histopathologically characterized by “specific” lymphocytic dermal infiltrates. Twenty patients presented skin tumors: melanoma(1), squamous and basal cell carcinoma (19). Eight patients had infectious diseases: genital warts, herpes infection, diffuse chronic dermatomycosis. Eighteen patients were affected by diffuse or limited eczematous dermatitis, whereas 8 patients presented psoriasis, 5 bullous diseases (pemphigus, pemphigoid, porphyria cutanea tarda), 4 urticaria, 4 rosacea, 3 seborrheic dermatitis, 2 livedo and 1 lichen planus. Seventeen patients had other skin lesions such as seborrheic keratosis, angiomas, etc. According to these findings we conclude that skin lesions during the course of B-CLL are not rare: they were found on 100 out of 800 patients affected by B-CLL., that is 12.5 % . These lesions are determined by different factors: the haemathological disease (B-CLL), the drugs used to treat it (chlorambucyl, steroids, interferon, etc), the age (elderly) and the general conditions (diabetes, other tumors, etc) of the patient. Skin tumors as well as viral and mycotic lesions could be considered the expression of lower immunologic defenses. The “specific” skin lesions are frequent (10 % ), but their prognostic value remains difficult to establish.