What Is Leukemia Cutis?

H. Colledge

Leukemia cutis is a rare condition in which leukemia cells are found in the skin. The resulting abnormal patches or growths, or skin lesions, can be a distinctive sign indicating that a person has leukemia. Most often, the condition appears at the same time as a diagnosed case of leukemia but, in a few cases, skin lesions may appear before leukemia is detectable or they may be seen after leukemia has resolved. Leukemia is a term used to describe a group of cancers which affect the bone marrow and blood, and which are associated with raised levels of white blood cells. Separate treatment for this condition is not generally carried out, and therapy is aimed at the underlying leukemia.

Chemotherapy drugs may be administered through a catheter located in a large vein in the chest.
Chemotherapy drugs may be administered through a catheter located in a large vein in the chest.

While leukemia can be associated with a number of skin conditions, they are more frequently nonspecific ones which could be caused by a number of diseases, such as the purple or red pinpoint spots known as petechiae. Leukemia cutis is what is known as a specific cutaneous manifestation of leukemia, in that it does not occur in association with other diseases. It may appear in the form of red or pink lumps, raised flattened areas known as plaques, or occasionally flat spots or ulcers. When a lump appears without any signs of leukemia, it is known as a granulocytic sarcoma, and such tumors may display a green coloration. Sometimes skin lesions develop in areas of the body where previous injury has occurred, such as burns or scars.

A diagram of normal blood and blood from someone with leukemia.
A diagram of normal blood and blood from someone with leukemia.

Most people with this condition have the most frequently occurring type of chronic leukemia, known as chronic lymphocytic leukemia. The condition also occurs in association with a number of other leukemias, including acute myeloid leukemia, chronic myeloid leukemia, prolymphocytic leukemia, and acute lymphoblastic leukemia. When leukemia cutis is found in adults, it signifies a worse prognosis. In those rare cases where children have congenital leukemia, meaning that they are born with the disease, the presence of leukemia cutis does not alter the prognosis.

For people who have leukemia, with or without this condition, treatment will vary according to the specific type of disease and the patient's general health. Typically, chemotherapy is given, with different drugs recommended to suit each kind of leukemia. Chemotherapy drugs are administered through a tube known as a catheter which may be inserted into a large vein in the chest. Unfortunately, even with treatment, the outlook for a person who has leukemia with this complication is often poor, with only a minority surviving for more than a year after diagnosis.

Most people with leukemia cutis have chronic lymphocytic leukemia.
Most people with leukemia cutis have chronic lymphocytic leukemia.

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Discussion Comments


@feruze-- @burcidi gave a good explanation. I just want to add that not every lesion seen in a leukemia patient is leukemia cutis. It's only leukemia cutis when the leukemic cells have infiltrated skin tissue. Otherwise, leukemia patients can have lesions, hyper-pigmentation, and even dermatitis because of the inflammation leukemia causes. Sometimes chemotherapy is also responsible for these lesions.

I just wouldn't want anyone who has leukemia to see that they have a lesion and assume that they are dying soon. You can't know what kind of lesion it is unless your doctor takes a biopsy and tests it.


@feruze-- Like the article said, unless the disease is congenital, meaning that the infant was born with leukemia, leukemia cutis is a sign of progression. These lesions are seen in various different types of leukemia. In adults, it is most prevalent in ATLL which is adult T-cell leukemia. In children, it's prevalent in congenital leukemia.

Doctors actually don't know how leukemia cells end up in the skin. It is believed that it has something to do with the various receptors on the cells. But you are right that disease occurs before the lesions.

The reason that diagnosis and the appearance of leukemia cutis often happens around the same time is because symptoms of the disease take time to show up. Leukemia cutis is usually seen along with other leukemia symptoms like fatigue, bruising and bleeding. But leukemia was definitely there before the lesions and other symptoms appeared.


How do leukemia cells end up in the skin?

As far as I know, as leukemia develops and worsens, more and more defective white blood cells accumulate in the body. And it's these cells that can eventually cause death for the person.

If leukemia cells have ended up in skin, shouldn't this always be a sign that leukemia has progressed? I don't understand how leukemia cutis can be present in a newly diagnosed patient. Does anyone know?

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