Plum-Colored Nodules in a Patient With Chronic Myelogenous Leukemia

REPORT OF A CASE  A 51-year-old woman with chronic myelogenous leukemia (CML) was seen by the dermatology service to evaluate an asymptomatic eruption that began approximately 4 months prior to admission. She had been hospitalized for treatment of an accelerated phase of her CML.The diagnosis of CML had been made 4 years previously when she presented with a white blood cell count of 40.0 × 10⁹/L, thrombocytopenia, and a differential cell count showing many immature myeloid cells but no blasts. A bone marrow examination showed increased myeloid and erythroid cells with a predominance of immature myeloid cells. Cytogenetic studies for the Philadelphia chromosome were positive.Initially, the patient was treated with busulfan and hydroxyurea but the medication was discontinued when she developed severe anemia. Other drug protocols were tried in the interim. She was receiving prednisone and hydroxyurea therapy when admitted for this most recent hospitalization.Physical