BEYOND OF MORPHOLOGY DIAGNOSIS: A CASE REPORT OF PIODERMA GANGRENOSO AS THE FIRST MANIFESTATION OF MYELODYSPLASTIC NEOPLASIA
Introduction: Pyoderma gangrenosum can be the first cutaneous manifestation of paraneoplastic syndromes. Among the associated diseases include hematological malignancies. These disorders may have atypical clinical characteristics, with the association of Myelodysplastic Neoplasm (MDS) with the bullo...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-10-01
|
| Series: | Hematology, Transfusion and Cell Therapy |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2531137923010027 |
| _version_ | 1797654888628355072 |
|---|---|
| author | NFAM Mendonça JVC Goes FJAB Ribeiro MA Viana AA Vieira RDB Dias RFP Filho NG Oliveira RTG Oliveira DP Borges HLR Junior SMM Magalhães RF Pinheiro |
| author_facet | NFAM Mendonça JVC Goes FJAB Ribeiro MA Viana AA Vieira RDB Dias RFP Filho NG Oliveira RTG Oliveira DP Borges HLR Junior SMM Magalhães RF Pinheiro |
| author_sort | NFAM Mendonça |
| collection | DOAJ |
| description | Introduction: Pyoderma gangrenosum can be the first cutaneous manifestation of paraneoplastic syndromes. Among the associated diseases include hematological malignancies. These disorders may have atypical clinical characteristics, with the association of Myelodysplastic Neoplasm (MDS) with the bullous form being the most described and its appearance associated with poor prognosis. Objective: To report a case of skin lesion as a first manifestation of MDS. Case report: A 68-year-old woman started with fatigue and pain in the legs, evolving with the appearance of plaques with haemorrhagic blisters in the left calf and the presence of cytopenia was identified in laboratory tests (Haemoglobin 6.7 g/dL, leukocytes 2.300/mm3, and neutrophils 552/mm3, and platelets 95.000/mm3). Patient sought medical assistance and started a clinical investigation. During follow-up serologies were performed with all negative results. Myelogram was performed and immunophenotyping showed the presence of 18.7% of myeloid lineage blasts with aberrant CD7 marking. The patient was diagnosed with MDS, the treatment with dapsone was started, but the patient died a few months after diagnosis. Discussion: The diagnosis of pyoderma gangrenous is one of exclusion and other causes of ulcer disease should be investigated. Myelodysplastic Neoplasm should always be considered in patients with pyoderma gangrenosum accompanied by some mono, bi or pancytopenia and may appear at the same time with the hematological disease or, in its evolution, as a marker of malignant transformation. Conclusion: Myelodysplastic neoplasm should always be considered in patients with pyoderma gangrenosum accompanied by some cytopenia. |
| first_indexed | 2024-03-11T17:06:11Z |
| format | Article |
| id | doaj.art-361eea7e2656490fadd1de4d02d75d85 |
| institution | Directory Open Access Journal |
| issn | 2531-1379 |
| language | English |
| last_indexed | 2024-03-11T17:06:11Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Hematology, Transfusion and Cell Therapy |
| spelling | doaj.art-361eea7e2656490fadd1de4d02d75d852023-10-20T06:43:45ZengElsevierHematology, Transfusion and Cell Therapy2531-13792023-10-0145S442BEYOND OF MORPHOLOGY DIAGNOSIS: A CASE REPORT OF PIODERMA GANGRENOSO AS THE FIRST MANIFESTATION OF MYELODYSPLASTIC NEOPLASIANFAM Mendonça0JVC Goes1FJAB Ribeiro2MA Viana3AA Vieira4RDB Dias5RFP Filho6NG Oliveira7RTG Oliveira8DP Borges9HLR Junior10SMM Magalhães11RF Pinheiro12Cancer Cytogenomic Laboratory, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos (NPDM), Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Post-Graduate Program in Medical Science, Universidade Federal do Ceará (UFC), Fortaleza, BrazilPost-Graduate Program in Patology, Universidade Federal do Ceará (UFC), Fortaleza, BrazilCancer Cytogenomic Laboratory, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos (NPDM), Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Post-Graduate Program in Medical Science, Universidade Federal do Ceará (UFC), Fortaleza, BrazilCancer Cytogenomic Laboratory, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos (NPDM), Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Post-Graduate Program in Medical Science, Universidade Federal do Ceará (UFC), Fortaleza, BrazilCancer Cytogenomic Laboratory, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos (NPDM), Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Post-Graduate Program in Medical Science, Universidade Federal do Ceará (UFC), Fortaleza, BrazilCancer Cytogenomic Laboratory, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos (NPDM), Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Post-Graduate Program in Medical Science, Universidade Federal do Ceará (UFC), Fortaleza, BrazilCancer Cytogenomic Laboratory, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos (NPDM), Universidade Federal do Ceará (UFC), Fortaleza, BrazilCancer Cytogenomic Laboratory, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos (NPDM), Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Post-Graduate Program in Medical Science, Universidade Federal do Ceará (UFC), Fortaleza, BrazilCancer Cytogenomic Laboratory, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos (NPDM), Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Post-Graduate Program in Medical Science, Universidade Federal do Ceará (UFC), Fortaleza, BrazilCancer Cytogenomic Laboratory, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos (NPDM), Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Post-Graduate Program in Medical Science, Universidade Federal do Ceará (UFC), Fortaleza, BrazilCancer Cytogenomic Laboratory, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos (NPDM), Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Post-Graduate Program in Patology, Universidade Federal do Ceará (UFC), Fortaleza, BrazilCancer Cytogenomic Laboratory, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos (NPDM), Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Post-Graduate Program in Medical Science, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Clinical Medicine Department, Universidade Federal do Ceará (UFC), Fortaleza, BrazilCancer Cytogenomic Laboratory, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos (NPDM), Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Post-Graduate Program in Medical Science, Universidade Federal do Ceará (UFC), Fortaleza, Brazil; Clinical Medicine Department, Universidade Federal do Ceará (UFC), Fortaleza, BrazilIntroduction: Pyoderma gangrenosum can be the first cutaneous manifestation of paraneoplastic syndromes. Among the associated diseases include hematological malignancies. These disorders may have atypical clinical characteristics, with the association of Myelodysplastic Neoplasm (MDS) with the bullous form being the most described and its appearance associated with poor prognosis. Objective: To report a case of skin lesion as a first manifestation of MDS. Case report: A 68-year-old woman started with fatigue and pain in the legs, evolving with the appearance of plaques with haemorrhagic blisters in the left calf and the presence of cytopenia was identified in laboratory tests (Haemoglobin 6.7 g/dL, leukocytes 2.300/mm3, and neutrophils 552/mm3, and platelets 95.000/mm3). Patient sought medical assistance and started a clinical investigation. During follow-up serologies were performed with all negative results. Myelogram was performed and immunophenotyping showed the presence of 18.7% of myeloid lineage blasts with aberrant CD7 marking. The patient was diagnosed with MDS, the treatment with dapsone was started, but the patient died a few months after diagnosis. Discussion: The diagnosis of pyoderma gangrenous is one of exclusion and other causes of ulcer disease should be investigated. Myelodysplastic Neoplasm should always be considered in patients with pyoderma gangrenosum accompanied by some mono, bi or pancytopenia and may appear at the same time with the hematological disease or, in its evolution, as a marker of malignant transformation. Conclusion: Myelodysplastic neoplasm should always be considered in patients with pyoderma gangrenosum accompanied by some cytopenia.http://www.sciencedirect.com/science/article/pii/S2531137923010027 |
| spellingShingle | NFAM Mendonça JVC Goes FJAB Ribeiro MA Viana AA Vieira RDB Dias RFP Filho NG Oliveira RTG Oliveira DP Borges HLR Junior SMM Magalhães RF Pinheiro BEYOND OF MORPHOLOGY DIAGNOSIS: A CASE REPORT OF PIODERMA GANGRENOSO AS THE FIRST MANIFESTATION OF MYELODYSPLASTIC NEOPLASIA Hematology, Transfusion and Cell Therapy |
| title | BEYOND OF MORPHOLOGY DIAGNOSIS: A CASE REPORT OF PIODERMA GANGRENOSO AS THE FIRST MANIFESTATION OF MYELODYSPLASTIC NEOPLASIA |
| title_full | BEYOND OF MORPHOLOGY DIAGNOSIS: A CASE REPORT OF PIODERMA GANGRENOSO AS THE FIRST MANIFESTATION OF MYELODYSPLASTIC NEOPLASIA |
| title_fullStr | BEYOND OF MORPHOLOGY DIAGNOSIS: A CASE REPORT OF PIODERMA GANGRENOSO AS THE FIRST MANIFESTATION OF MYELODYSPLASTIC NEOPLASIA |
| title_full_unstemmed | BEYOND OF MORPHOLOGY DIAGNOSIS: A CASE REPORT OF PIODERMA GANGRENOSO AS THE FIRST MANIFESTATION OF MYELODYSPLASTIC NEOPLASIA |
| title_short | BEYOND OF MORPHOLOGY DIAGNOSIS: A CASE REPORT OF PIODERMA GANGRENOSO AS THE FIRST MANIFESTATION OF MYELODYSPLASTIC NEOPLASIA |
| title_sort | beyond of morphology diagnosis a case report of pioderma gangrenoso as the first manifestation of myelodysplastic neoplasia |
| url | http://www.sciencedirect.com/science/article/pii/S2531137923010027 |
| work_keys_str_mv | AT nfammendonca beyondofmorphologydiagnosisacasereportofpiodermagangrenosoasthefirstmanifestationofmyelodysplasticneoplasia AT jvcgoes beyondofmorphologydiagnosisacasereportofpiodermagangrenosoasthefirstmanifestationofmyelodysplasticneoplasia AT fjabribeiro beyondofmorphologydiagnosisacasereportofpiodermagangrenosoasthefirstmanifestationofmyelodysplasticneoplasia AT maviana beyondofmorphologydiagnosisacasereportofpiodermagangrenosoasthefirstmanifestationofmyelodysplasticneoplasia AT aavieira beyondofmorphologydiagnosisacasereportofpiodermagangrenosoasthefirstmanifestationofmyelodysplasticneoplasia AT rdbdias beyondofmorphologydiagnosisacasereportofpiodermagangrenosoasthefirstmanifestationofmyelodysplasticneoplasia AT rfpfilho beyondofmorphologydiagnosisacasereportofpiodermagangrenosoasthefirstmanifestationofmyelodysplasticneoplasia AT ngoliveira beyondofmorphologydiagnosisacasereportofpiodermagangrenosoasthefirstmanifestationofmyelodysplasticneoplasia AT rtgoliveira beyondofmorphologydiagnosisacasereportofpiodermagangrenosoasthefirstmanifestationofmyelodysplasticneoplasia AT dpborges beyondofmorphologydiagnosisacasereportofpiodermagangrenosoasthefirstmanifestationofmyelodysplasticneoplasia AT hlrjunior beyondofmorphologydiagnosisacasereportofpiodermagangrenosoasthefirstmanifestationofmyelodysplasticneoplasia AT smmmagalhaes beyondofmorphologydiagnosisacasereportofpiodermagangrenosoasthefirstmanifestationofmyelodysplasticneoplasia AT rfpinheiro beyondofmorphologydiagnosisacasereportofpiodermagangrenosoasthefirstmanifestationofmyelodysplasticneoplasia |