A 6-year-old boy was assessed for a pruriginous swelling of the scalp that had been present for 2 weeks and had persisted after a week of. A bacterial scalp infection was initially diagnosed locally but the lesion continued to increase in size with the development of prominent occipital. Kerion is the result of the host’s response to a fungal ringworm infection of the hair follicles of the scalp (occasionally the beard) that can be accompanied by.
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February 11, Accepted Date: March 01, Published Date: Leukemia Cutis Mimicking Kerion Celsi: A challenging Diagnosis for Clinicians.
Acute lymphoblastic leukemia ALL is an acute form of leukemia, characterized by the overproduction of immature white blood cell progenitors, known as lymphoblasts . The peak incidence occurs between two and five years of age.
Acute lymphoblastic leukemia ALL is an acute form of leukemia, characterized by the overproduction of immature white blood cell progenitors, known as lymphoblasts [ 1 ].
Each year approximately to new cases of ALL are diagnosed in children kerlon the United States. Nearly 70 to 80 percent of cases of childhood ALL are of B-precursor ceksi i.
The most common presenting symptoms of ALL are nonspecific e. Herein we report the case of a three year old girl with B cell ALL presenting with a nodule on the scalp skin, mimicking kerion celsi tinea capitis profunda.
A 3 year old girl presented to our dermatology outpatient clinic with a nodule on the scalp of 4 weeks duration.
She used topical and oral antibiotics and antifungals, without any improvement. She was healthy otherwise. The hair keerion the nodule came out in clumps with gentle tugging. She had also multiple swollen posterior cervical lymph nodes.
A possible differential diagnosis for her presentation includes kerion celsi or dissecting cellulitis of the scalp. A native preparate examination was made but no hyphae were seen.
Leukemia Cutis Mimicking Kerion Celsi: A challenging Diagnosis for Clinicians
A fungal culture of the scale was celxi. On review a month later, there was no improvement. The culture on Sabouraud dextrose agar did not show any growth. A skin biopsy was performed. Histopathologic examination showed malignant lymphoid infiltration. She was referred to the pediatric hematology department. Her complete blood count was as follows: Physical examination showed hepatosplenomegaly cervical lymphadenopathy in addition to the nodule.
Bone marrow aspiration was performed and morphological and flow cytometric analysis was consistent kreion B cell ALL. Therefore the patient was enrolled in the high risk group.
Vomiting, abdominal distension, constipation and fever were observed. On the abdominal tomography, images of celxi were obtained. Despite granulocyte suspension and intravenous immunoglobulin, antibiotherapy and plasma exchange, the patient did not improve and eventually died Figure 3.
[Kerion celsi. Clinical aspects and pathogenesis of deep trychophytosis of the scalp].
Herein we describe a 3-year-old girl with a nodule on the scalp resembling kerion celsi as a clinical presentation of leukemia cutis. Kerion is the inflammatory extreme form of dermatophyte infection, caused by a vigorous T-cell-mediated host response to the dermatophyte infection [ 5 ]. It manifests as painful and suppurative plaques or nodules, accompanied by purulent drainage.
The most affected area is the scalp, and it may result in scarring alopecia if treatment is delayed. Keerion pathogens to trigger kerion include Trichophyton mentagrophytes, Trichophyton verrucosum, Microsporum canis, Trichophyton tonsurans and Microsporum gypseum [ 6 ].
Leukemic skin infiltrates are a rare feature of ALL. A biopsy reveals a diffuse infiltrate of leukemic blasts around blood vessels and between collagen bundles [ 7 ]. There are no preferred sites of involvement in leukemia cutis LC.
KERION CELSI OF THE SCALP IN AN ADULT
Until recently, there were few studies about leukemia cutis presentation in childhood. Twenty four children had skin lesions at the time of diagnosis of the hematologic malignancy. The most commonly involved areas were the head.
They described the lesions asymtomatic papules and nodules brown- red to violence without ulceration.
Another study comprising seventy five children reported the nodule as the most common lesion and the extremities as the most frequent localization [ 9 ]. There have been many studies about B-cell proliferative disorders mimicking other kerio disorders e. However there are no reports about B-cell proliferative disorders mimicking dermatophytosis in the literature. Our patient presented keriin a solitary cutaneous nodule with a yellow crust.
The native preparate examination was negative. However due to the fact that she had used topical antifungals we accepted the nodule as dermatophytosis.
One other fact which supported our diagnosis was that the hair on the nodule came out in clumps with gentle tugging, so we tried to treat our patient with kerrion systemic antifungal. As we did not observe any improvement after one month with antifungal treatment, a skin biopsy was made. Histopathology showed neoplastic lymphoid infiltration. High grade B cell lymphoma was diagnosed. LC often has rapid disease progression and poor prognosis.
The mean interval between diagnosis of LC and death was reported as 3. The interval time was 2 months for our patient.
An early diagnosis is essential in LC. The dermatologist plays a pivotal role in determining these suspected patients and in referring them to a hematologist.
All Published work is licensed under a Creative Commons Attribution 4.
A Simple Treatment for Kerion Celsi: Solid Carbon Dioxide | JAMA Dermatology | JAMA Network
March 10, Citation: Visit for more related articles at Clinical Pediatric Dermatology. Introduction Acute lymphoblastic leukemia ALL is an acute form of leukemia, characterized by the overproduction of immature white blood cell progenitors, known kerikn lymphoblasts [ 1 ]. Case Report A 3 year old girl presented to our dermatology outpatient clinic with a nodule on the scalp of 4 weeks duration. Select your language of interest to view the total content in your interested language.
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