Mucocutaneous Manifestations in Hematological Malignancies

Abstract

Internal malignancy may be associated with a wide variety of mucocutaneous manifestations. These provide a useful indicator of disease activity and prognosis. An awareness of possible associations between internal malignancies and mucocutaneous manifestations is therefore important in the diagnosis and management of cancer.

HM are associated with various mucocutaneous lesions. These may be due to malignancy itself, chemotherapy received, associated infections, nutritional deficiencies and paraneoplastic syndromes. .

In this study we wanted to detect the various mucocutaneous manifestations those occur in patients with HM and to determine its possible etiological factors.

Between12/2011 to12/2014, data was collected from 45 Egyptian, children and adolescents, from pediatric hematology oncology clinic, Pediatric Hospital, Ain Shams University with various HM and mucocutaneous lesions. The patients divided according to diagnosis in to ALL in (64.4 %); AML in (11.1 %); NHL in (15.6 %) and HL in (8.9 %).

All studied patients were subjected to full history taking; anthropometric measures (weight, height and body mass index); dermatological examination. Complete blood count; total serum protein; serum albumin and C reactive protein were also performed. Skin biopsy and cultures were performed for confirmation of diagnosis when indicated.

All patients complained of non-cutaneous symptoms. Fever was the main symptoms in patients of our study, followed by pallor, splenomegaly, lymphadenopathy, hepatomegaly, bleeding manifestations, abdominal mass, bone and joint pain.

Alopecia was the most frequent lesion found in (37.8%) in the studied patients; followed by stomatitis in (28.9%); hyperpigmentation in (26.7%); extravasation in (15.6%) and ecchymosis in (13.3%). Eczema was the most common miscellaneous lesion in 13.3%). Impetigo was detected in (8.9%) as the most frequent infectious lesion, followed by plane warts in (6.7%). paraneoplastic in form of sweet syndrome was the least common detected lesion in (2.2%).

In the current study on 45 patients with HM and mucocutaneous lesions , chemotherapy adverse reactions were being the most common etiology factor in 62.2% ( 28 patients) and paraneoplastic the least common in 2.2%( 1 patient). Infections were detected in 33.3% (15 patients). Hemorrhagic causes in 15.5% (7 patients). While non infectious non hemorrhagic (miscellaneous) causes were found in 22.2% (10 patients).

Incidence of malnutrition at patients with mucocutaneous lesions related to HM ranged from 20% to 42.2% depending upon the measurement used. It could suggest as etiological factor