Discussion
Leukemia cutis is rare, affecting approximately 3% of leukemia
patients1. It can present as papules, nodules,
plaques, erythema, purpura, or eczematiform rash. Typically, lesions are
multiple; solitary lesions are very rare, and ulceration and severe
erythema are uncommon2. Notably, no previous reports
describe a hemangioma-like appearance as observed in our case.
Generally, leukemia cutis appears in individuals already diagnosed with
leukemia, and it is exceedingly rare for it to be the initial sign of
hematologic malignancy (aleukemic leukemia cutis)3.
Although our patient presented with a hemangioma-like lesion at 7 weeks
of age, aleukemic leukemia cutis could not be ruled out as no laboratory
tests were performed at that time. The initial presentation as an
infantile hemangioma, combined with the lesion’s atypical firmness on
exam and the presence of systemic symptoms, suggested a more serious
etiology. Biopsy remains the gold standard for accurate diagnosis in
atypical cases4.