Abstract
Leukemia cutis is the infiltration of neoplastic leukocytes or their precursors into the epidermis, dermis, and subcutaneous tissue, resulting in various cutaneous manifestations. A young girl presented with multiple painful hard indurated nodules and plaques over the abdomen, back, breast, and bilateral lower limbs for 4 months. Biopsy showed a dense lymphocytic infiltrate seen with large atypical lymphocytes. Immunohistochemistry (IHC) revealed positivity for CD34, C-KIT, and Glycophorin A. Peripheral smear revealed 32% blast cells. Bone marrow aspirate were suggestive of hyper-cellular marrow with myeloid preponderance. IHC showed myeloperoxidase (MPO) negativity which led to the diagnosis of leukemia cutis secondary to myelodysplastic syndrome with blast showing myelomastocytic differentiation with MPO negative acute leukemia.
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