Leukemia Cutis in a Patient with Metastatic Pancreatic Cancer: A Case Report
Jay Patel,
Emily Powell,
Sarah Al-Awami,
Chen Chen,
Yve Huttenbach,
Benjamin Musher,
Ida Orengo
Issue:
Volume 4, Issue 1, June 2021
Pages:
1-4
Received:
27 April 2021
Accepted:
12 May 2021
Published:
21 May 2021
DOI:
10.11648/j.ijcd.20210401.11
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Abstract: Background: Leukemia cutis is an extramedullary manifestation of leukemia with infiltration of neoplastic leukocytes into the epidermis, dermis, or subcutaneous tissues. Most often it is associated with myelodysplastic syndrome or acute myelogenous leukemia. Case History: Here we present a patient with new-onset, multiple, non-tender red papules, that were initially concerning for skin metastases of her previously diagnosed pancreatic ductal adenocarcinoma. She was previously diagnosed with pancreatic cancer six years prior and was in remission until one year prior when she was found to have pulmonary metastases. The metastatic pulmonary nodules were successfully treated with radiotherapy, and the patient was in surveillance prior to presenting with a two month history of rapidly growing pink nodules on her skin. Results: Skin biopsies initially indicated this was likely not metastatic pancreatic adenocarcinoma but rather a hematologic malignancy with monocytic blast dermal infiltration. A subsequent bone-marrow biopsy and staining indicated a second primary hematologic malignancy, acute myelogenous leukemia. With the patient’s previous chemotherapy history, this new malignancy could have been treatment related. However, genetic analysis revealed this was not likely as it did not harbor known phenotypes or markers of treatment related myelodysplastic syndrome or acute myelogenous leukemia including myelomonocytic leukemia with eosinophils (FAB M4EO) or an inversion in chromosome 16 (p13q22). Instead, cytogenetics and next-generation sequencing showed trisomy 8 and a gain of function missense mutation in U2AF1. Conclusion: Maintaining a broad differential and utilizing sequential diagnostic testing confirmed a blast phase de novo acute myelogenous leukemia, presenting as leukemia cutis. She was treated with decitabine and venetoclax and within a few days of initiation, her skin nodules had already begun to recede.
Abstract: Background: Leukemia cutis is an extramedullary manifestation of leukemia with infiltration of neoplastic leukocytes into the epidermis, dermis, or subcutaneous tissues. Most often it is associated with myelodysplastic syndrome or acute myelogenous leukemia. Case History: Here we present a patient with new-onset, multiple, non-tender red papules, t...
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Impacts of Acupuncture Therapy on Herpes Zoster: Report of 3 Cases
Ramon Hernandez Sarduy,
Kevin Raul Hernandez Chinea,
Lissette Irene Lopez Pena,
Maridalys Hernandez Chinea,
Edilberto Pena Leyva,
Marte Antonio Valdes Ibargollin
Issue:
Volume 4, Issue 1, June 2021
Pages:
5-9
Received:
5 May 2021
Accepted:
31 May 2021
Published:
30 June 2021
DOI:
10.11648/j.ijcd.20210401.12
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Abstract: There were three cases (64, 44 and 81 years of age, all male) referred to the rehabilitation service of the Ophthalmology specialty, with the diagnosis of ophthalmic herpes zoster, due to intense pain and macular lesions, vesicles on erythematous base in the periorbital and frontal region, accompanied by intense edema. 64, 44 and 81 years old in order of appearance. Also treated, in the first instance, by dermatology with: analgesics (Dipyrone, Paracetamol), non-steroidal anti-inflammatory drugs (Ibuprofen, Piroxicam), injectable B-complex vitamin therapy, physiological therapy, eye drops and saline solutions. Pain intensity was measured by the Visual Analog Scale (VAS), at the beginning and at the end of the treatment. Acupuncture treatment for 6 to 9 sessions began on different days of the evolution of her illness. The same acupuncture treatment scheme was applied to the three patients: bilateral LI-4 (Hegu) and LI-11 (Quchi). In points on the face, the needles were placed on the healthy side: UB-2 (Zanzhu), SI-17 (Yifeng) and GB-1 (Tungtzuliao). After the first acupuncture session the pain ceased or lessened, and the blisters began to dry up. None had ocular complications and post-herpetic neuralgia did not appear after three months of finishing acupuncture therapy. The evolution was satisfactory in the 3 patients.
Abstract: There were three cases (64, 44 and 81 years of age, all male) referred to the rehabilitation service of the Ophthalmology specialty, with the diagnosis of ophthalmic herpes zoster, due to intense pain and macular lesions, vesicles on erythematous base in the periorbital and frontal region, accompanied by intense edema. 64, 44 and 81 years old in or...
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