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Myelodysplastic syndrome presenting as generalized granulomatous dermatitis.
MedLine Citation:
PMID:  21422341     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Granulomatous dermatitis has rarely been reported as a manifestation of leukemia or myelodysplastic syndrome (MDS). We describe a case of widespread granulomatous dermatitis that preceded the diagnosis of MDS by 2 years.
OBSERVATIONS: A 71-year-old man developed a generalized, mildly pruritic eruption that slowly progressed over a 2-year period. Punch biopsy specimens demonstrated interstitial dermal granulomatous inflammation. A complete blood cell count with differential showed marked monocytosis, and the findings of a subsequent biopsy of the bone marrow confirmed MDS. Lenalidomide therapy was initiated, and the patient's skin condition improved after 6 weeks of treatment; however, his MDS progressed to acute myeloid leukemia, and he died shortly thereafter.
CONCLUSIONS: There is a paucity of literature documenting the occurrence of granulomatous dermatitis as a manifestation of an underlying hematologic disorder. This case illustrates a striking example of widespread granulomatous dermatitis heralding the onset of MDS. It is imperative that the dermatologic community recognize the rare association of granulomatous dermatitis with myelodysplasia, because the cutaneous manifestations may be the presenting finding and can precede the development of leukemia by several years.
Authors:
Samuel J Balin; David A Wetter; Paul J Kurtin; Louis Letendre; Mark R Pittelkow
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of dermatology     Volume:  147     ISSN:  1538-3652     ISO Abbreviation:  Arch Dermatol     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372433     Medline TA:  Arch Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  331-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905. wetter.david@mayo.edu.
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