Aleukemic leukemia cutis: a rare case report

Leukemia cutis is a rare case disorder characterised by infiltration of neoplastic leukocytes (myeloid or lymphoid) in clinically identifiable cutaneous lesions. It can occur before the onset of hematological presentation of leukemia or during the disease course. The lesions may be highly variable ranging from flesh coloured to violaceous papules, nodules or plaques. A 52-year-old male patient came to the Dermatology Department with multiple asymptomatic erythematous papulonodular lesions involving the face, trunk as well as the extremities from the past 6 months. Systemic examination and counts were normal. On histopathological examination diffuse dense infiltrate of neutrophils and eosinophils throughout the dermis with extension of infiltrate in the interstitium of reticular dermis. Scattered amidst the infiltrate were several large cells with abundant pale cytoplasm and irregular nuclei. Immunohistochemistry was done, radiotherapy was planned and poor prognosis was explained to the patient. The case is being reported due to its rarity and the role of dermatopathologist in early diagnosis.