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Mucocutaneous manifestations in a case of eosinophilic variant of chronic myeloid leukaemia

thromboembolism and have often received heparins repeatedly. A delayed-type hypersensitivity reaction has been proposed, requiring prior sensitisation to heparin. One systematic review reported that among patients with a primary sensitisation to unfractionated heparin, as suspected in our patient, the overall risk of cross-reaction to other heparins was 72.2%. Discontinuation of treatment may not be necessary as the lesions are often self-limiting despite continued use of heparin, typically resolving within weeks without complications. Since the Koebner phenomenon can play a role, dermatologists should be aware that pre-existing pruritic conditions or new pruritus associated with the development of these lesions can lead to a more persistent and disseminated disease form. Heparin-induced skin lesions may indicate the presence of life-threatening heparin-induced thrombocytopaenia. An early diagnosis is therefore crucial to enable timely cessation of heparin if required. Alternatively, knowledge of the characteristic clinical features of heparin-induced bullous haemorrhagic dermatosis including its favourable prognosis should preclude clinicians from terminating this potentially life-saving treatment.