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A patient with T4+ (helper-inducer) T cell chronic lymphocytic leukemia developed an erythema multiforme-like eruption, the diagnosis of which was supported by routine light microscopic findings. Immunopathologic studies using monoclonal antibodies demonstrate that despite an overwhelming majority of leukemic T4+ cells in the peripheral blood and dermal infiltrate, the predominant cells in the epidermal infiltrate are T8+ (cytotoxic-suppressor) cells. These findings are different from those seen in epidermotropic T cell leukemic infiltrates and are similar to those previously reported in erythema multiforme. Thus it is likely that the leukemic T4+ cells are participating in this cutaneous hypersensitivity reaction along with residual, normal T8+ cells. more...

Immunocompromised patients are more susceptible to unusual pathogens. The case of an immunocompromised patient who presented with cellulitis as the only manifestation of disseminated cryptococcosis is reported. The literature on cryptococcal cellulitis is reviewed. more...

Periosteal reaction is a commonly encountered radiographic finding. Differential diagnoses include trauma, infection, and neoplasia. Biopsy may be necessary for the definitive diagnosis. Surgical trauma to an inflamed periosteum can stimulate a rapid and tremendous bone-forming response. more...