[Effectiveness of topical application of nitroglycerin spray to increase survival of cutaneous flaps and grafts].

Actas Dermosifiliogr. 2007;98:291-5 294 transferase, CD30, CD3, CD20, serum protein S-100, CD119, and CD34. Based on these findings, the patient was diagnosed with leukemia cutis (LC). Specifically, the diagnosis was chloroma, or infiltration by myeloid or granulocytic sarcoma. The patient was referred to the reference hospital for pediatric oncology, Hospital La Fe de Valencia, Spain, where a bone marrow biopsy was taken, showing 60% blasts. Bone marrow immunophenotyping showed that the infiltrate was composed of 54% myeloid cells (CD33+ in 100%, CD13+ in 42%) and 19% neutrophils, and the final diagnosis was established as acute myelomonocytic leukemia (M4). A spinal tap ruled out the presence of blasts in the cerebrospinal fluid, and all other examinations were normal or negative (echocardiogram, electrocardiogram, cerebral ultrasound, bone scan, and infectious serology (hepatitis B and C virus, human immunodeficiency virus, herpes simplex virus, varicella-zoster virus, and toxoplasmosis). He received induction chemotherapy under the SHOP-LANL 2001 protocol and required 2 cycles to obtain complete remission. After the consolidation cycle, the patient underwent a transplant of hematopoietic stem cells from his HLA identical donor twin brother. Specific leukemic infiltrates may present in various morphological forms such as papules, nodules, purpura, ulcerations, and more rarely, blisters. They may found at any site, including in areas of trauma or scars, but are more common on the head, neck, or trunk.1 LC is uncommon in childhood, with only a few cases published in children.2-6 It appears more often in congenital leukemia (25%-30% of cases).2,3 As in adults, it is associated with acute myeloid leukemia,4 particularly in carriers of the monocyte markers M3 and M5 (10%-30%). There is a strong association between specific cutaneous infiltration and the presence of leukemia in other extramedullary sites (cerebrospinal fluid, spleen, liver, lymph nodes, and gums). Unlike adults, in whom LC is associated with a severe prognosis, in children it does not alter the natural progression of the disease.