Are skin ulcers associated with Hairy Cell Leukemia (HCL)?

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Last updated: February 23, 2025View editorial policy

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From the Guidelines

Skin ulcers are not a primary symptom of Hairy Cell Leukemia (HCL), but they can occur as a secondary complication, particularly due to compromised immune function, reduced platelet counts, or infiltration of leukemia cells into the skin. According to the consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia 1, skin rash and secondary skin tumors are potential adverse effects of BRAF inhibitors, such as vemurafenib, which may be used to treat HCL. Key considerations for skin ulcers in HCL patients include:

  • Compromised immune function, leading to increased susceptibility to infections
  • Reduced platelet counts, causing poor wound healing and easy bruising
  • Infiltration of leukemia cells into the skin in advanced cases Management of skin ulcers in HCL patients typically involves:
  • Treating the underlying HCL with chemotherapy or targeted therapies, such as BRAF inhibitors
  • Proper wound care and dressing changes
  • Antibiotics if infection is present
  • Platelet transfusions if thrombocytopenia is severe It is essential for patients to monitor their skin for any unusual sores or lesions and report them to their healthcare provider promptly, as early detection and treatment of skin ulcers can prevent complications and improve overall outcomes in HCL patients 1.

From the Research

Skin Ulcers in Hairy Cell Leukemia

  • Skin ulcers are not specifically mentioned as a common manifestation of Hairy Cell Leukemia (HCL) in the provided studies 2, 3, 4, 5, 6.
  • However, cutaneous findings such as skin lesions, infections, and nonherpetic ulcerations are reported in patients with HCL 5.
  • A study from 1984 found that nonherpetic ulcerations were among the nonspecific cutaneous findings in patients with HCL, although the frequency of skin ulcers was not specified 5.
  • Another study from 2010 reported a case of a patient with HCL who presented with cutaneous lesions, including leukemic maculopapulous infiltration of the skin, but did not mention skin ulcers specifically 2.
  • The association between skin ulcers and HCL is not well-established in the provided literature, and more research may be needed to determine the relationship between the two 3, 4, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Skin changes in hairy cell leukemia.

Annals of hematology, 2021

Research

Cutaneous findings in hairy cell leukemia.

Journal of the American Academy of Dermatology, 1984

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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