International Journal of Hematology

, Volume 80, Issue 1, pp 59–61 | Cite as

Exaggerated Cutaneous Response to Mosquito Bites in a Patient with Chronic Lymphocytic Leukemia

  • Keiko Asakura
  • Masahiro KizakiEmail author
  • Yasuo Ikeda
Case Report


Although various cutaneous manifestations can occur in patients with chronic lymphocytic leukemia (CLL), bullous lesions due to mosquito bites are rare. We describe a patient with a typical case of CLL complicated by exaggerated cutaneous response to mosquito bites. The symptoms of this patient were self-limited and not severe, but it has been reported that the treatment of such symptoms is sometimes difficult. Because exaggerated cutaneous hypersensitivity to mosquito bites can be observed even before the diagnosis of hematological malignancies such as CLL, careful examinations are recommended to find underlying diseases in cases in which this type of cutaneous reaction occurs.

Key words

Exaggerated cutaneous response Mosquito bite Chronic lymphocytic leukemia 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Epstein E, MacEachern K. Dermatologic manifestations of the lymphoblastoma-leukemia group. Arch Intern Med. 1937;60:867–875.CrossRefGoogle Scholar
  2. 2.
    Stawisky MA. Cutaneous manifestations of leukemias and lymphomas. In: Callen JP, ed. Cutaneous Aspects of Internal Disease. Chicago: Year Book Medical Publishers; 1981;239–256.Google Scholar
  3. 3.
    Stawisky MA. Skin manifestations of leukemias and lymphomas. Cutis. 1978;21:814–818.Google Scholar
  4. 4.
    Weed RI. Exaggerated delayed hypersensitivity to mosquito bites in chronic lymphocytic leukemia. Blood. 1965;26:257–268.PubMedGoogle Scholar
  5. 5.
    Blum RR, Phelps RG, Wei H. Arthropod bites manifesting as recurrent bullae in a patient with chronic lymphocytic leukemia. J Cutan Med Surg. 2001;5:312–314.CrossRefGoogle Scholar
  6. 6.
    Binet JL, Auquier A, Dighiero G, et al. A new prognostic classification of chronic lymphocytic leukemia derived from a multivari- ate survival analysis. Cancer. 1981;48:198–206.CrossRefGoogle Scholar
  7. 7.
    Rai KR, Sawitsky A, Cronkite EP, Chanana AD, Levy RN, Paster-nack BS. Clinical staging of chronic lymphocytic leukemia. Blood. 1975;46:219–234.PubMedGoogle Scholar
  8. 8.
    Weller PF. Human eosinophils. J Allergy Clin Immunol. 1997;100:283–287.CrossRefGoogle Scholar
  9. 9.
    Davis MDP, Perniciaro C, Dahl PR, Randle HW, McEvoy MT, Leiferman KM. Exaggerated arthropod-bite lesions in patients with chronic lymphocytic leukemia: a clinical, histopathologic, and immunopathologic study of eight patients. J Am Acad Dermatol. 1998;39:27–35.CrossRefGoogle Scholar
  10. 10.
    Mori T, Okamoto S, Kuramochi S, Ikeda Y. An adult patient with hypersensitivity to mosquito bites developing mantle cell lym- phoma. Int J Hematol. 2000;71:259–262.PubMedGoogle Scholar
  11. 11.
    Penneys NS, Nayar JK, Bernstein H, Knights JW. Circulating antibody detection in human serum to mosquito salivary gland proteins by the avidin-biotin peroxidase technique. J Am Acad Dermatol. 1988;18:87–92.CrossRefGoogle Scholar
  12. 12.
    Simons FER, Peng Z. Mosquito allergy: recombinant mosquito salivary antigens for new diagnostic tests. Int Arch Allergy Immunol. 2001;124:403–405.CrossRefGoogle Scholar
  13. 13.
    Ishihara S, Ohshima D, Tokura Y, et al. Hypersensitivity to mosquito bites conceals clonal lymphoproliferation of Epstein-Barr viral DNA-positive natural killer cells. Jpn L Cancer Res. 1997;88:82–87.CrossRefGoogle Scholar
  14. 14.
    Tokura Y, Ishihara S, Tagawa S, Seo N, Ohshima K, Takigawa M. Hypersensitivity to mosquito bites as the primary clinical manifestation o f a juvenile type of Epstein-Barr virus-associated natural killer cell leukemia/lymphoma. J Am Acad Dermatol. 2001;45:569–578.CrossRefGoogle Scholar
  15. 15.
    Kawa K, Okamura T, Yagi K, Takeuchi M, Nakayama M, Inoue M. Mosquito allergy and Epstein-Barr virus-associated T/natural killer-cell lymphoproliferative disease. Blood. 2001;98:3173–3174.CrossRefGoogle Scholar
  16. 16.
    Barzilai A, Shpiro D, Goldberg I, et al. Insect bite-like reaction in patients with hematologic malignant neoplasms. Arch Dermatol. 1999;135:1503–1507.CrossRefGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2004

Authors and Affiliations

  1. 1.Division of Hematology, Department of Internal MedicineKeio University School of MedicineTokyoJapan

Personalised recommendations