An unusual case of T-cell prolymphocytic leukemia mimicking a cutaneous vasculitis.

T-cell prolymphocytic leukemia (T-PLL) is an aggressive post-thymic T-cell malignancy, which accounts for 2% of mature lymphocytic leukemias in adults. Though typically presenting with a brief history of B symptoms, hepatosplenomegaly, and marked lymphocytosis, erythematous or nodular skin rashes involving the trunk or limbs may be seen in 25% to 30% of patients, as well as a purpuric rash in a periorbital distribution. Cutaneous involvement typically presents in the context of patients with an established history of T-PLL, but it can less frequently present as an initial symptom heralding the diagnosis.

Dissecting cellulitis treated with the long-pulsed Nd:YAG laser.

Background: Dissecting cellulitis is a chronic inflammatory scalp condition characterized by pustular nodules, sinus tract formation, and resultant cicatricial alopecia. Current treatments are of limited efficacy.

Objective: This report explored treating dissecting cellulitis with the long-pulsed Nd:YAG laser to determine the capabilities and limitations of this modality with respect to: (1) reducing pus formation; (2) enabling the termination of systemic treatments; (3) investigating the side-effect profile including dyspigmentation and scarring alopecia; and (4) terminating the disease process.