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Disseminated Granuloma Annulare Associated with Chronic Myelogenous Leukemia

To the Editor: Disseminated granuloma annulare (GA) is known to have associations with numerous systemic disorders, including hematopoietic malignancies, and it has been reported to have a tendency to present atypical clinical features, especially when associated with malignant lymphoma or AIDS (1–4). We describe a case of disseminated GA with an atypical clinical presentation in chronic myelogenous leukemia (CML). On May 23, 2002, a 5-year-old Korean girl presented with a 10-day history of multiple asymptomatic erythematous papules and nodules involving both extremities and her face. In December of 2001, she had been diagnosed with CML and had undergone four cycles of chemotherapy consisting of hydroxyurea, interferon, and cytosine arabinoside. The final chemotherapy was finished on March 20, 2002. She also had hepatosplenomegaly with mild fever. There was no lymph node enlargement. She had multiple, discrete, well-defined, pea-sized, non-tender, round erythematous papules and nodules on the extremities and several, well-defined, small erythematous papules on both cheeks. Most of the skin lesions were seen on the lower legs (Fig.1). Laboratory data were as follows: white blood cell count: 8,800/μl with prominent eosinophilThe Journal of Dermatology Vol. 30: 631–633, 2003