Prevalence and prognostic value of cutaneous manifestations in patients with myelodysplastic syndrome

• Published in: Journal of the European Academy of Dermatology and Venereology 2010-10, Vol.24 (10), p.1171-1175
• Main Authors: Farah, C, Bulai Livideanu, C, Jegu, J, Paul, C, Viraben, R, Lamant, L, Delavigne, K, Adoue, D, Laurent, G, Beyne Rauzy, O
• Format: Article
• Language: English
• Subjects: Adult; Aged; Bone marrow; Cell survival; Cohort Studies; cohort study; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; leucocytoclastic vasculitis; Leukemia, Myeloid, Acute - epidemiology; Leukocytes (neutrophilic); Male; Middle Aged; Myelodysplastic syndrome; Myelodysplastic Syndromes - complications; Myelodysplastic Syndromes - diagnosis; neutrophilic dermatosis; Prevalence; Prognosis; Prospective Studies; Retrospective Studies; Risk assessment; Risk Factors; Skin diseases; Skin Diseases - epidemiology; Skin Diseases - etiology; Transformation; Vasculitis
• ISSN: 0926-9959; 1468-3083
• DOI: 10.1111/j.1468-3083.2010.03614.x

Background  Skin manifestations associated with myelodysplastic syndrome (MDS) may reveal bone marrow transformation into acute myeloid leukaemia. Objective  The objective of this study was to assess the prevalence of skin manifestations associated with MDS. In addition, we evaluated the risk of acute myeloid leukaemia transformation associated with skin manifestations. Methods  We studied a cohort of 157 patients with primary MDS followed up prospectively for a median of 44 months. Skin lesions were prospectively assessed as part of medical examination every 6 months by a board certified dermatologist. Survival analyses were performed to assess the association between the presence of skin lesions and the risk of acute myeloid leukaemia. Results  Fifteen patients (9.55%) experienced skin lesions previously reported as associated with MDS. These were neutrophilic dermatosis (7, 4.46%), specific lesions (5, 3.18%), cutaneous vasculitis (2, 1.27%) and Behçet disease (1, 0.63%). Survival analysis showed that the risk of transformation into acute myeloid leukaemia was slightly but not significantly increased in patients with skin lesions as compared with patients without skin lesions with a relative risk of 2.08 (95% CI 0.92–4.67). Conclusion  The prevalence of skin lesions, mostly neutrophilic dermatosis and specific lesions, is relatively high in patients with MDS. There is a trend for a higher risk of transformation into acute myeloid leukaemia in patients with skin lesions.