Neutrophilic Dermatosis in Chronic Myelomonocytic Leukemia
An adult male who had chronic myelomonocytic leukemia was evaluated for 3 months of hemorrhagic bullae on the hands. Empiric antimicrobial therapy with linezolid, Bactrim, and isavuconazole had provided minimal relief. Physical examination revealed plaques with necrotic crust overlying the metacarpo- and proximal interphalangeal joints with surrounding desquamation and violaceous borders (Figure 1). No other cutaneous or mucosal involvement was present. He had a leukocytosis of 45,500/μL with a manual absolute neutrophil count of 41,000/μL.
