DISSEMINATED CUTANEOUS GRANULOMATOUS ERUPTIONS ASSOCIATED WITH MYELODYSPLASTIC SYNDROME AND ACUTE MYELOID-LEUKEMIA

Two elderly male patients presented with similar, widespread, papular, granulomatous eruptions and developed myelodysplastic syndromes. The first showed histological features of diffuse granuloma annulare and h ad mild hypergammaglobulinaemia, slightly abnormal liver function and a leucoerythroblastic anaemia. He developed acute myeloid leukaemia (A ML) secondary to a background myelodysplastic syndrome and was treated with combination chemotherapy during which his eruption settled; his AML and his skin are in remission 1 year later. The second developed a myelodysplastic syndrome and a similar rash with histological feature s of papular cutaneous sarcoidosis but no systemic abnormalities apart from mild hypergammaglobulinaemia, cutaneous anergy to multiple recal l antigens and activation of circulating monocytes. He has remained we ll but his rash and myelodysplastic syndrome have persisted. These cas es are interesting because of the striking similarity of their granulo matous eruptions and their associated haematological abnormalities. Pa tients with such disseminated, granulomatous cutaneous infiltrations s hould be investigated to exclude associated haematological abnormaliti es if there is any abnormality of their peripheral blood picture.