Atopic dermatitis (AD) is a chronic recurrent dermatitis with intense itching. AD could be the first manifestation of acute myeloid leukemia (AML). A Chinese man, aged 53 years had a 6-month history of systemic symmetrical dermatitis, which was accompanied with intense itching. The patient was detected as "eczema" in some hospitals, and the medicinal effects of antihistamine and topical steroid creams were very poor. Night-time sleep was extremely affected by aggravating pruritus. Pathological investigation was compatible with AML-M4. He was diagnosed as AML-M4 with AD as first manifestation.

IA regimen (ayninen and cytarabine) were used in initiation of chemotherapy. But, the patient did not attain complete remission, and even though his rash had improved, he still experienced severe general itching of the body. On the 7th day of chemotherapy, the patient moved in the period of granulocyte deficiency with infection. Unfortunately, the patient died due to septic shock after chemotherapy.

This case report supports the awareness of AML with AD as first manifestation and increases oncological alertness in patients with refractory AD.

Source: Ma WW, Kasyanju Carrero LM, Yin XF, Liu HF, Zhou BR. Acute myeloid leukemia with adult atopic dermatitis as first manifestation: A case report. Medicine (Baltimore). 2019; 98(32):e16362. doi:10.1097/MD.0000000000016362