Hematolojik Malignite Tanısı Olan Hastalarda Dermatolojik Lezyonların Değerlendirilmesi

Öz

Hematolojik malignite tanısı olan hastalarda dermatolojik lezyonların değerlendirilmesi amaçlanmıştır. Çalışmamız yapılırken 2019-2024 yıllarında hematolojik malignite tanısı olan demografik veriler, hematolojik hastalık tanıları, hastalık süresi, klinik özellikler, dermatoloji konsültasyonu ile elde edilen dermatolojik muayene verileri cilt lezyonlarından alınan biyopsilerin patoloji sonuçları ve diğer malignite varlığı hasta dosya kayıtlarından retrospektif olarak incelenecektir. Toplam 241 hematolojik maligniteli hasta dâhil edilmiştir. Olguların ortanca yaşı 64 olup, erkek/kadın oranı 1,3’tür. En sık tanı %24,1 ile akut myeloid lösemi (AML), ardından %18,3 ile multipl miyelom (MM) ve %17,4 ile non-Hodgkin lenfoma (NHL) gelmiştir. Lezyonların en sık rastlanan tipi %14,9 oranla dermatit olurken, bunu ilaç reaksiyonu (%14,5) ve mantar enfeksiyonları (%13,3) takip etmiştir. AML grubunda en sık lezyon dermatit ve mantar enfeksiyonu, MM grubunda ise ilaç reaksiyonu belirlenmiştir. Lenfomalı hastalarda anlamlı şekilde daha sık ürtiker görülmüştür (p=0,004). Hastaların %81,7’si lezyon gelişme döneminde kemoterapi almakta olup, en sık kullanılan ajanlar alkilleyiciler (%24,9), antimetabolitler (%22,8) ve steroidlerdir (%21,2). Biyopsi yapılan hastaların %20’sinde ilaç ilişkili dermatolojik reaksiyon ve vaskülit raporlanmıştır. Hastaların %98,8’ine sistemik tedavi kesilmeden lokal/topikal destek tedavileri uygulanmıştır. Hematolojik malignitelerde dermatolojik lezyonların hem tedavi ilişkili hem de hastalık progresyonuyla bağlantılı olabileceğini göstermektedir. AML, MM ve NHL gibi farklı hematolojik hastalıklarda dermatolojik bulguların tipi değişiklik göstermektedir. Özellikle lenfomalı hastalarda ürtikerin daha sık görülmesi bu alt grubun izleminde dikkat edilmesi gereken bir bulgu olarak öne çıkmaktadır. Lezyonların büyük çoğunluğu tedaviye ara verilmeden yönetilebilmiş olup, lokal destek tedaviler yeterli olmuştur. Bu bulgular dermatolojik muayenenin hematolojik hastaların rutin izleminde önemli bir parça olması gerektiğini ortaya koymaktadır.

Anahtar Kelimeler

• Malignite
• lezyon
• hematoloji
• dermatoloji

Evaluation of Dermatological Lesions in Patients With Hematologic Malignancy

Öz

The purpose of this study was to assess dermatological lesions in hematologic malignancy patients. Patient file records pertaining to patients diagnosed with hematologic malignancies and followed up in our center between 2019 and 2024 will be retrospectively examined for demographic information, hematologic disease diagnoses, clinical features, dermatological examination data obtained with dermatology consultation, pathology results of biopsies taken from skin lesions, and the presence of other malignancies. The study comprised 241 participants with hematologic malignancies. The male to female ratio was 1.3, and the median age was 64. Acute myeloid leukemia (AML) accounted for 24.1% of diagnoses, while multiple myeloma (MM) came in second with 18.3%. With a rate of 14.9%, dermatitis was the most frequent form of lesion, followed by drug response (14.5%). In the AML group, dermatitis and fungal infection were the most frequent lesions, while in the MM group, medication reactions were more common. Patients with malignancy experienced urticaria considerably more frequently (p=0.004). At the time of lesion development, 81.7% of the patients were receiving chemotherapy, with alkylating drugs being the most frequently utilized agents (24.9%). Twenty percent of individuals who had biopsies reported having vasculitis and drug-related dermatological responses. 98.8% of the patients received local/topical supportive treatments without stopping systemic treatment. According to this study, dermatological lesions in hematologic malignancies may be connected to the course of the disease as well as treatment. These results imply that routine follow-up for hematologic patients should include a dermatological evaluation.

Anahtar Kelimeler

• Malignancy
• lesion
• hematology
• dermatology

Kaynakça

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