RT Journal Article
SR Electronic
T1 Atypical neutrophilic panniculitis as presentation of BCR-ABL1-negative chronic myeloid leukaemia
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e232005
DO 10.1136/bcr-2019-232005
VO 12
IS 10
A1 Fraticelli, Paolo
A1 Benfaremo, Devis
A1 Cardinali, Marco
A1 Gabrielli, Armando
YR 2019
UL http://casereports.bmj.com/content/12/10/e232005.abstract
AB We report the case of an otherwise healthy 60-year-old man presenting with fever, leucocytosis and a painful swelling of the right calf. We initially performed cultural and cytological examination of the popliteal fossa mass, but the results were disappointingly inconclusive. The subsequent development of several erythematous subcutaneous nodules, rapidly evolving to broad ulcerative lesions, prompted us to reconsider the clinical setting as a whole, which included fever, marked leucocytosis and multiple subcutaneous nodules. A biopsy of the ulcerative lesions finally led to the diagnosis of neutrophilic panniculitis, which was sustained by a hybrid myelodysplastic/myeloproliferative disorder like BCR-ABL1-negative atypical chronic myeloid leukaemia. The patient was initially treated with high-dose intravenous corticosteroids, resulting in a dramatic improvement of the skin lesions and normalisation of blood tests. Azacytidine treatment was subsequently started, and the haematological disease remained stable.