الفهرس 
Hematological Malignancies
LeukemiaOnly 14 pages are availabe for public view
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Abstract
Internal malignancy may be associated with a wide variety of mucocutaneous
manifestations. These provide a useful indicator of disease activity and prognosis. An
awareness of possible associations between internal malignancies and mucocutaneous
manifestations is therefore important in the diagnosis and management of cancer.
HM are associated with various mucocutaneous lesions. These may be due to
malignancy itself, chemotherapy received, associated infections, nutritional
deficiencies and paraneoplastic syndromes. .
In this study we wanted to detect the various mucocutaneous manifestations those
occur in patients with HM and to determine its possible etiological factors.
Between12/2011 to12/2014, data was collected from 45 Egyptian, children and
adolescents, from pediatric hematology oncology clinic, Pediatric Hospital, Ain
Shams University with various HM and mucocutaneous lesions. The patients divided
according to diagnosis in to ALL in (64.4 %); AML in (11.1 %); NHL in (15.6 %) and
HL in (8.9 %).
All studied patients were subjected to full history taking; anthropometric measures
(weight, height and body mass index); dermatological examination. Complete blood
count; total serum protein; serum albumin and C reactive protein were also performed.
Skin biopsy and cultures were performed for confirmation of diagnosis when
indicated.
All patients complained of non-cutaneous symptoms. Fever was the main symptoms in
patients of our study, followed by pallor, splenomegaly, lymphadenopathy,
hepatomegaly, bleeding manifestations, abdominal mass, bone and joint pain.Alopecia was the most frequent lesion found in (37.8%) in the studied patients;
followed by stomatitis in (28.9%); hyperpigmentation in (26.7%); extravasation in
(15.6%) and ecchymosis in (13.3%). Eczema was the most common miscellaneous
lesion in 13.3%). Impetigo was detected in (8.9%) as the most frequent infectious
lesion, followed by plane warts in (6.7%). paraneoplastic in form of sweet syndrome
was the least common detected lesion in (2.2%).
In the current study on 45 patients with HM and mucocutaneous lesions ,
chemotherapy adverse reactions were being the most common etiology factor in
62.2% ( 28 patients) and paraneoplastic the least common in 2.2%( 1 patient).
Infections were detected in 33.3% (15 patients). Hemorrhagic causes in 15.5% (7
patients). While non infectious non hemorrhagic (miscellaneous) causes were found in
22.2% (10 patients).
Incidence of malnutrition at patients with mucocutaneous lesions related to HM
ranged from 20% to 42.2% depending upon the measurement used. It could suggest as
etiological factor
Conclusion
In conclusion, hematological malignancies are associated with various mucocutaneous
manifestations either due to the malignancy itself, chemotherapy received; associated
infections, nutritional deficiencies and paraneoplastic syndromes, prophylaxis against
these factors must be emphasized.
Alopecia was the most frequent mucocutaneous lesion found in 37.8%; followed by
stomatitis in 28.9% and hyperpigmentation in 26.7%. Paraneoplastic syndrome was
the least frequent lesion only in 2.2 %.Mucocutaneous manifestations in HM were found in 45 patients (100%) in the current
study, mainly due to chemotherapy adverse reactions in 62.2%.
Incidence of malnutrition at patients with mucocutaneous lesions related to HM
ranged from 20% to 42.2% depending upon the measurement used. It could suggest as
etiological factor.