An Atypical Chronic Ulcer Caused by Acute Myeloid Leukemia.

INTRODUCTION

Atypical chronic wounds are challenging for clinicians because of their identification, diagnosis, and treatment. These wounds may reflect an underlying systemic or malignant disease; therefore, an accurate diagnosis and initiation of the appropriate treatment are necessary.

CASE REPORT: A 68-year-old man presented with an atypical chronic ulcer on his left shin of 2 years' duration. The ulcer was associated with acute myeloid leukemia. Initially, the surgeon treated the chronic wound with wide debridement and biopsy for pathohistological investigation. Leukemia cutis with accumulation of blast cells in the area of the ulcer was recognized by histological examination. Further, an absorbent cellulose-based core dressing with activated carbon was used, which appeared to be useful in reducing wound pain, odor, and exudate.

CONCLUSIONS

Leukemia cutis is a specific sign of systemic leukemia and the result of dissemination of leukemic cells to the skin. Treatment should be directed towards eradication of the systemic disease, which also improves local manifestation of the disease.