Cutaneous involvement in leukaemic patients. A review of the literature and personal experience.

: The authors, on the basis of a review of the literature and on their personal experience, derived from the observation of 169 cases of acute and chronic leukaemias, describe the different aspects of the cutaneous lesions present during the course of these neoplastic conditions. The cutaneous lesions, subdivided according to the type of leukaemia, show an extremely variable pattern and it is therefore difficult to differentiate on the basis of the sole macroscopic appearances, specific leukaemic nodules or infiltrates from dermatoses due to bacterial, viral and fungal infections on which an haemorrhagic component may be superimposed. Similarly, if a clearly established diagnosis of leukaemia has not been confirmed, it is difficult to distinguish leukaemic infiltrates from cutaneous lesions caused by a malignant lymphoma, metastatic carcinoma, an eosinophilic granuloma, or from benign lymphohistiocytic infiltrates, secondary to cutaneous infections. It is important also to bear in mind the development of skin eruptions, often with an haemorrhagic component, due to acquired sensitivity to numerous agents, cytostatic drugs, antibiotics, blood products and others, used in therapy. The authors therefore underline the importance of an early recognition of an infectious lesion, often complicated by a previous haemorrhagic event or secondary to microbial invasion of a catheter tip or of a venipuncture site, and consequently, the authors emphasize the need to distinguish these non-specific skin alterations, amenable to appropriate treatment from those lesions due to the development of a skin tumour or to a leukaemic infiltrate, which is nearly always indicative of a leukaemia recurrence or extension of the leukaemic process.