Hematology-Oncology Tutorial

Pallor

Pale color of the mucous membranes and skin—particularly in locations where vessels are close to the surface (eg, palmar creases and nail beds).

Koilonychia

Describes thinning of the nail and loss of its normal convex shape to become flat or concave.

Petechial rash

Petechiae and purpura are the result of extravasation of blood from the vasculature into the skin or mucosa, usually occurring in the dependent regions of the body. Petechiae are pinpoint hemorrhages ≤2 mm in size, purpura are 2 mm to 1 cm in size, and ecchymoses are >1 cm in size. These lesions do not blanch with pressure.

Sweet’s syndrome

One of the neutrophilic dermatoses, Sweet’s syndrome can be idiopathic, malignancy-associated, and drug-induced. It presents with tender erythematous skin lesions in the form of papules, nodules, and/or plaques.

Cutaneous lymphoma

B or T cell lymphomas that involve the skin, manifesting with a variety of skin lesions.Characterized by the sudden development of multiple seborrheic keratoses, associated with an underlying malignancy.

Radiation Tattoos

The presence of tattoo markers on the skin can be a helpful clue to previous external beam radiation therapy. Look for blue macules that are around 2-4 mm in size.

Purpura fulminans

A thrombotic disorder that occurs as a result of congenital or acquired protein C deficiency, often caused by sepsis, particularly involving certain organisms (eg, Neisseria meningitidis).

Leser-Trélat sign

Characterized by the sudden development of multiple seborrheic keratoses, associated with an underlying malignancy.

Amyloidosis

A condition in which abnormal proteins are deposited throughout the tissues of the body. Characteristic physical findings include macroglossia, enlarged shoulders (shoulder pad sign), and purpura (including racoon eyes). 

 

Breast cancer

Usually manifests as a palpable and/or visible mass in the breast. A particular subtype, called inflammatory breast cancer, presents with breast swelling and thickening and hardening of the skin overlying the lesion resembling an orange peel (peau d’orange).

 

Sources and further reading:

  • Leung AK, Chan KW. Evaluating the child with purpura. Am Fam Physician. 2001;64(3):419-428.