Trauma-induced Spread of Acute Myeloid Leukemia to the Skin and Small Intestine: A Potential Form of “Koebnerization” that is More than Skin Deep.
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Keywords
Acute Myeloid Leukemia, Myeloid Sarcoma, Leukemia Cutis, Koebnerization, Isomorphic Response
Abstract
Leukemia Cutis (LC) is a form of myeloid sarcoma (MS) that describes the extramedullary spread of leukemic cells to the skin, such as by Acute Myeloid Leukemia (AML). While LC occurs in 3-4% of patients with AML, rarely has it been reported secondary to trauma, a form of isomorphic response or Koebnerization (N=3). Another form of MS that has not been documented, to our knowledge, is surgical-induced trauma leading to AML infiltrating the small intestine. The present case describes biopsy-supported Koebnerization of AML to the skin (LC) and small intestine (MS), both induced by surgical incisions. Overall, trauma-induced dissemination of AML is an important diagnostic consideration and prognostic indicator for non-healing wounds of the skin and, potentially, the gastrointestinal tract in patients with AML.
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