Chilblains as a non-specific skin eruption in a patient with myelodysplastic neoplasm
- By Ken Shiraishi,
- Yukihiro Miyazaki,
- Nobushige Kohri,
- Satoshi Yoshida,
- Kazuki Yatsuzuka,
- Jun Muto,
- Masamoto Murakami
- and Yasuhiro Fujisawa
Pages 298 to 300
Cite this article
- SHIRAISHI, Ken,
- MIYAZAKI, Yukihiro,
- KOHRI, Nobushige,
- YOSHIDA, Satoshi,
- YATSUZUKA, Kazuki,
- MUTO, Jun,
- MURAKAMI, Masamoto
- and FUJISAWA, Yasuhiro,
- Shiraishi, Ken.,
- et al.
- Shiraishi, K.,
- Miyazaki, Y.,
- Kohri, N.,
- Yoshida, S.,
- Yatsuzuka, K.,
- Muto, J.,
- Murakami, M.
- and Fujisawa, Y.
https://doi.org/10.1684/ejd.2024.4680
Cite this article
- Shiraishi, K.,
- Miyazaki, Y.,
- Kohri, N.,
- Yoshida, S.,
- Yatsuzuka, K.,
- Muto, J.,
- Murakami, M.
- and Fujisawa, Y.
- Shiraishi, Ken.,
- et al.
- SHIRAISHI, Ken,
- MIYAZAKI, Yukihiro,
- KOHRI, Nobushige,
- YOSHIDA, Satoshi,
- YATSUZUKA, Kazuki,
- MUTO, Jun,
- MURAKAMI, Masamoto
- and FUJISAWA, Yasuhiro,
https://doi.org/10.1684/ejd.2024.4680
A 71-year-old man with pancytopaenia was referred to the haematology division of our hospital. A haematologist conducted a bone marrow examination, which confirmed the diagnosis of myelodysplastic neoplasm (MDS). The patient exhibited erythematous swelling of the fingers and toes, followed by the development of violaceous plaques on his nose and cheeks after two months. He had no family or personal history of chilblains or autoimmune diseases. These eruptions did not respond to topical corticosteroids, prompting a referral to our department. Physical examination revealed well-demarcated violaceous plaques, localised on the tip of the nose and bilateral cheeks (figure 1A, B). The ear helix exhibited violaceous discolouration (figure 1B), and the dorsum of the fingers demonstrated erythematous swelling and violaceous plaques (figure 1C). Our initial differential diagnoses included chilblain, chilblain lupus, sarcoidosis, and cryoglobulinaemic vasculitis. Blood tests revealed severe pancytopaenia attributed to MDS. Neither anti- nuclear antibodies nor other autoantibodies were detected. C3 and C4 levels were within normal range. Cryoglobulins and anti-neutrophil cytoplasmic antibodies were not detected. Skin biopsy of the cheek revealed follicular plugging and dense lymphohistiocytic infiltration around vessels and appendages in the dermis (figure 1D-F); no lichenoid changes were observed at the dermo-epidermal junction (figure 1D). Additionally, telangiectatic vessels and red blood cell extravasation were present …
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