Tariq Zaman, Muhammad Jahangir, Muhammad Abbas Raza, Tahir Saeed Haroon.
Spectrum of cutaneous infections in patients of leukemia.
J Pak Assoc Derma Jan ;14(4):220-7.

Background: Cutaneous infections are common in patients of leukemia due to immunosuppression caused by the disease itself and its therapy. Objectives: This study was aimed to analyze the incidence, types and clinical presentations of various cutaneous infections in different types of leukemias in this part of the world. Patients and methods: This observational, descriptive and cross sectional study was carried out in department of dermatology, King Edward Medical College & Mayo Hospital, Lahore. Two hundred and fifty diagnosed patients of leukemia were enrolled from pediatrics, oncology, dermatology and medical units of Mayo Hospital, Lahore. Detailed dermatological examination was performed and the cases having any skin infection were further investigated. The incidence and morphological patterns of various cutaneous infections in leukemia were analyzed. Results: Out of the 250 enrolled patients, cutaneous infections were present in 177 (71%) patients. Out of these 177 patients, 101(57%) were male while 76(43%) were female. The age ranged from 2-76 years. Infections of skin were more common in acute as compared to chronic leukemias (p< 0.01). Candidiasis was the commonest infection (72%) seen, while bacterial, viral and dermatophytic infections were present in 31%, 35% and 12% of the patients, respectively. Scabies was found in 12%. More than half of the patients (54%) had two or three types of concomitant infections. Bacterial infections were more frequent in myelogenous leukemias (p < 0.001), while candidal and dermatophytic infections were more common in lymphocytic leukemias (p<0.001 and < 0.05, respectively). Dissemination, higher grade of severity and atypical morphology was frequently seen with these infections. Conclusions: The incidence of cutaneous infections in leukemic patients is very high and these are more common in acute as compared to chronic leukemia. Candidiasis is the commonest infection. Bacterial infections are more frequent in myelogenous leukemias, whereas superficial fungal infections are more in lymphocytic leukemias. Infections with higher degree of severity, dissemination and atypical morphology are common.

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