Clinical Features

Patients with ALL have lymphadenopathy in up to 80% and hepatomegaly and/or splenomegaly in up to 75% of the cases (1). Skin involvement is rare and almost always associated with pre-B-cell phenotype. Most commonly, when specific lesions of ALL occur in the skin, they present as multiple red to violaceous papules, plaques, or nodules, which may occasionally ulcerate. The most frequent location of specific skin lesions in children is on the head (3). Cutaneous involvement can be an early manifestation of ALL; skin lesions may be present during weeks to several months before the diagnosis of hematologic disease (3,4).

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