Leukemia Cutis as the Presenting Sign of Acute Myeloid Leukemia in an HIV+ patient

Leukemia Cutis (LC) is a rare extramedullary cutaneous manifestation of leukemia that varies in terms clinical presentation, type, and timing presentation relation to systemic leukemia. LC typically presents following diagnosis during an active flare or relapse. An estimated 3.7% patients with Acute Myeloid (AML) develop LC. A 61-year-old male poorly controlled HIV presented rash began one month prior on his cheek as red papule, which he believed was ingrown hair. On exam, pink yellow firm papules nodules covered entire body surface except the groin axilla. One nodule held peau d’orange appearance. The overall asymptomatic, reported only increased fatigue. His CD4 count viral load were 136 330,000 respectively. punch biopsy revealed negative cultures for fungus, bacteria, acid-fast bacilli. Two biopsies sent pathologic evaluation AML skin. Bone marrow confirmed AML. Clinically nonspecific, symptoms rarely appear conjunction High suspicion histopathologic examination are necessary