Cutaneous manifestations of leukemia; plus the science of natural ingredients, and oral lichen planus' prevalence

Dermatology Weekly

Leukemia cutis should be high on the differential in patients presenting with leukemia. Dr. Vincent DeLeo talks with Dr. Lindsay Strowd and Wasim Haidari about their research on the presentation of leukemia cutis and clinical implications. “For us as dermatologists, to recognize that you may not know that the patient has leukemia at the time that you’re actually evaluating them I think points to the need to biopsy any spots that look unusual or a little bit different in nature,” notes Dr. Strowd.

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We bring you the latest in dermatology news and research:

1. Oral lichen planus prevalence estimates go global
2. Dr. Daniel Siegel discusses the translational science behind natural ingredients

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Things you will learn in this episode:

• Leukemia cutis tends to present in patients with acute myeloid leukemia (AML) but also can present in other forms of the disease.
• Clinically, leukemia cutis is thought to present most commonly as solitary nodules, but recent research revealed that the primary presentation may include multiple papules or other unusual presentations such as mucosal and ulcerative lesions.
• Thorough and comprehensive full skin examinations are important in patients with leukemia: “Biopsy for leukemia cutis certainly is most times diagnostic for the disease, but I think paying attention to the entire skin surface of a patient with leukemia is also vitally important because [lesions] are not always going to present on the trunk or the arms or legs where they’re easily identifiable. Some of our patients have lesions on the scalp, the mucosal surfaces like the oral mucosa, and in the genital region as well,” says Dr. Strowd.
• Leukemia cutis can present at various stages during the course of leukemia, and time to diagnosis varies depending on subtype. For AML, study results indicated that the average interval between diagnosis of leukemia and leukemia cutis was about 5 months; however, many patients developed cutaneous findings at the onset of leukemia or with relapse.
• Leukemia cutis is considered a negative prognostic factor and may be associated with a shorter overall mortality in leukemia patients.
• It is important for dermatologists to have a good close working relationship with their oncology colleagues to facilitate prompt evaluation of leukemia patients who may present to their oncologist or another specialist with cutaneous findings.

Hosts: Elizabeth Mechcatie; Terry Rudd; Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles)

Guests: Lindsay Strowd, MD, and Wasim Haidari, BS, BA (Wake Forest School of Medicine, Winston-Salem, North Carolina)

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Show notes by: Alicia Sonners, Melissa Sears, Elizabeth Mechcatie

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