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Giornale Italiano di Dermatologia e Venereologia 1998 December;133(6):435-8

Copyright © 1998 EDIZIONI MINERVA MEDICA

language: Italian

Granulomatosis eruption associated with acute myeloid leukemia

Satta R. 1, Montesu M. A. 1, Masala M. V. 1, Cocco L. 2, Cottoni F. 1

1 Università degli Studi - Sassari, Istituto di Clinica Dermatologica; 2 Università degli Studi - Sassari, Istituto di Anatomia Patologica


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A 40 year-old man, with a history of acute myeloid leukemia (ALM) treated with chemotherapy and isotretinoin, developed a papular eruption. Histopathological examination of a lesion showed a granuloma annulare-like pattern with rare giant cells and a palisading array of histiocytes. In the literature, granulomatous inflammation in internal organs in association with Hodgkin’s and non-Hodgkin’s lymphoma has been described. Cutaneous granulomatous lesions have rarely been reported in association with hematopoietic malignancy. The biologic relation between granulomatous inflammation and hemathologic malignancies is a matter of speculation. For some authors, granulomatous inflammation in association with hemathologic malignancy may be observed by chance. In fact, very few cases have been recorded. Some other authors believe that hematological diseases may themselves cause an immunodeficiency leading to granulomatous responses to unidentified infective organisms or a cell-mediated immunity to tumoral antigens. In the case observed, the patient obtained cutaneous lesion disappearance over the subsequent 3 months after discontinuation of isotretinoin therapy. A search of the literature showed contradictory opinions on the action of isotretinoin and further investigation is necessary. Furthermore, the role of ALM or isotretinoin therapy in the development of granuloma annulare-like lesions is considered.

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