Myelodysplastiches Syndrom und leukozytoklastische Vaskulitis. Übersicht über Myelodysplasie-assoziierte Hauterkrankungen

Myelodysplastic syndrome (MDS) is a hematologic disorder, that includes a spectrum of diseases from refractory anemia to myelo-monocytic leukemia. Common feature is the progressive failure of bone marrow function. Early symptoms are anemia, infections as well as skin and mucosal bleedings. Primary MDS is differentiated from the secondary MDS. Secondary MDS can occur after a radiation or chemo-therapy of a malignant systemic disease. The incidence of MDS is increasing, which might partly be due to the increasing number of patients that survive a malignant disease after therapy. We report a case of a 65 year old woman who presented with refractory anemia one year after chemotherapy and radiation for a carcinoma of the breast. Parallel to progression of her disease to refractory anemia with excess of blasts in transformation to acute leukemia (RAEB-T), she developed plaque like lesions on mucous membranes, face and trunk. On histopathological examination, the lesions showed signs of leukocytoclastic vasculitis. Other skin diseases associated with MDS are Sweet's syndrome, pyoderma gangraenosum, erythema elevatum et diutinum, opportunistic infections and leukemic skin infiltration. There is a predisposition for »neutrophilic dermatoses« in MDS. The diagnostic value of these dermatoses with regard to the prognosis of the disease, e.g. malignant transformation remains to be elucidated.