PMC3420723_01
Skin necrosis in the d12 of induction daunorubicin-cytarabine.
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fig1
At D8 of treatment and during postchemotherapy aplasia, the patient has impaired consciousness with a Glasgow Coma Score at 12; following the transfusion of apheresis platelet pellets (APP), the symptoms have spontaneously regressed after 24 h, and brain scan came back normal. 4 days later, the patient developed a skin necrosis in the pelvis and internal faces of thighs (Figures 1(a) and 1(b)) with mucocutaneous haemorrhagic syndrome made of bloody sputum, spontaneous ecchymoses on both legs, and petechial purpura of the neck and trunk, all operating in a context of dyspnea, fever among 39 C, and hemodynamic stability.
(High magnification) fibrinoid necrosis of vessel walls with perivascular myxoid degeneration.
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fig2
The focal areas of the thrombi were composed of fibrin, whereas the major portion of these thrombi were metachromatic, indicating that they were mainly composed of platelets which characterizes TMA (Figure 2).