We describe 3 patients with acute myeloid leukemia (AML) who had skin infiltrations of leukemic cells. Case 1 was a 73-year-old man with red-infiltrated erythema on his face, trunks, shoulder, and inguinal region. Case 2 was a 74-year-old woman with a pruritic red-brownish eruption on her trunk. Case 3 was a 27-year-old woman; cutaneous nodules appeared on her head 40 months after chemotherapy and a peripheral blood stem cell transplantation for AML. The histology of the skin biopsy specimens of all 3 cases revealed dense infiltrations of blasts that were immunoreactive for myeloperoxidase and CD68. In Cases 1 and 2, bone marrow examination disclosed AML. The skin lesions disappeared after chemotherapy for AML in the first 2 cases and after irradiation in the last case. Macroscopic findings in the specific skin lesions varied among the cases. Specific skin lesions are important for diagnosis of the first evidence of AML or as extramedullary manifestations of relapse in a previously treated AML case in remission.
We treated a case of hemopneumothorax in 74-year-old man with hemangiosarcoma of the scalp by intrapleural injection of Paclitaxel. This administration is the first trial with Paclitaxel. The drug transition into the blood flow was at a very low concentration. Slight pleural pain and delayed neutropenia were observed, but the treatment was well tolerated. The hemopneumothorax has not recurred in more than ten months since the treatment. We suggest that this therapy can be useful for hemopneumothorax caused by hemangiosarcoma.
We examined the clinical data from 61 cases of sebaceous carcinoma diagnosed at the Sapporo Institute for Dermatopathology from May 2001 to August 2006. They included male 27 cases and 34 female cases. The average age at resection was 74.0±12.1 year-old. In 21 cases (35.2%), the lesions were located on eyelid; in 25 cases (35.2%), on head and neck regions other than the eyelids, and, in 14 cases (24.1%), on regions other than the head and neck. Clinically, the lesions on the eyelids were most frequently diagnosed as malignant neoplasms, but those on extra-ocular regions were diagnosed as benign neoplasms. About half of the lesions on the eyelids were resected by ophthalmologists, whereas over half of the extra-ocular cases were resected by dermatologists. We compared the number of cases of sebaceous carcinoma with those of other cutaneous malignant neoplasms diagnosed at our Institute during the same period. The number of basal cell carcinoma cases was 30 times, that of squamous cell carcinoma cases was 15 times, and that of malignant melanoma and Extramammary Paget’s disease was three times higher than those of sebaceous carcinoma, although the number of sweat gland carcinomas was lower. The cases of sebaceoma were three times more frequent than those of sebaceous carcinoma; in contrast, those of sebaceous adenoma were less than half as frequent.
Bone mineral density (BMD) and body composition were examined using a cross-sectional study of patients undergoing glucocorticoid treatment at the Dermatology Clinic of Kyoto University Hospital. The BMD of the radius was significantly lower than that of the age-matched population. In addition, the changes in the BMD of the lumbar spine paralleled the average daily dosage of glucocorticoid. We found no correlation between parameters reflecting the body composition and the cumulative or average daily dosage of glucocorticoid. However, in one case available for long-term follow-up, the effects of corticosteroid on muscle loss and fat gain were evident. It appears that the changes of muscle and fat tissue, which have more rapid metabolisms than bone, were not detected by this cross-sectional study.