以丘疹结节为首发表现的早期急性单核细胞白血病一例

Early acute monocytic leukemia with papular nodules as the first presentation:a case report

急性单核细胞白血病以多发性丘疹和结节为首发表现且经皮肤活检、骨髓活检明确诊断的个案报道较少。本例急性单核细胞白血病患者就诊时全身泛发绿豆至指甲盖大小暗红色斑、丘疹、结节,双眼内侧睑缘绿豆大小红色肉芽肿样增生,并未出现明显血象指标异常,仅出现单核细胞比率升高,提示皮肤科医师应结合皮损临床表现重视血液系统肿瘤的早期不典型血象改变。

There are few case reports of acute monocytic leukemia with multiple papules and nodules as the initial manifestation and a definite diagnosis by skin biopsy or bone marrow biopsy.The patient with acute monocytic leukemia presented with dark red macules,papules,and nodules ranging from mung beans to nail LIDS were found all over the body at the time of admission,and mung beans sized red granulomatous hyperplasia was found on the inner eyelid margin of both eyes.There was no obvious abnormality in blood parameters,only the proportion of monocytes was increased.It is suggested that dermatologists should take into account the early atypical blood changes of hematological tumors in combination with clinical manifestations of skin lesions.