Dermatological conditions in haematology patients: Data from combined haematology/dermatology clinic

Aim/Background: Haematology patients often have dermatological issues, either directly associated with their disease or because of their increased risk profile. These include benign, malignant and infective conditions. Not only are some of these patients at increased risk of dermatology malignancies (both melanoma and non-melanoma), but it has been shown that, for CLL patients, skin cancers progress more rapidly(1). In light of this, early detection of malignancies is of particular importance. To facilitate this, and the timely identification of other dermatological conditions, a combined Haematology / Dermatology tertiary referral clinic was established at the Royal North Shore Hospital of Sydney, New South Wales.
Method: Retrospective audit of patient presentations to the combined haematology/dermatology clinic from May 2013 to October 2016.
Results: From May 2013 to October 2016, 124 CLL patients were reviewed over 395 appointments. Through these consultations, 13.7% of patients were diagnosed with skin cancer, with the majority being non-melanoma. 11.2% had infective processes, including viral, bacterial and fungal causes. 2.4% had cutaneous manifestations of CLL. Of the remaining benign conditions, a significant proportion were dermatitis (16.9%), drug exanthems (4.8%) and exaggerated insect bite reactions (3.2%)
Conclusion: The combined haematology/dermatology clinic provides timely diagnosis and appropriate clinical care for patients with concurrent haematological conditions. It provides opportunity for early detection of skin cancers, for which CLL patients are at high risk, and streamlined referral to specialist treatment including surgical and radiotherapy when required.
1. Royle, J.A., et al., Second cancer incidence and cancer mortality among chronic lymphocytic leukaemia patients: a population-based study. Br J Cancer, 2011. 105(7): p. 1076-81

Dr. Anthea Mulcahy

St George Dermatology and Skin Cancer Centre

Dr Anthea Mulcahy is a clinical research fellow to Associate Professor Stephen Shumack and Dr Adrian Lim in Sydney, NSW. Anthea gained her medical degree from the University of Tasmania and moved to Sydney in 2015 to follow her passion of Dermatology.