Cutaneous manifestations in patients with essential thrombocythemia

Thrombocythemia is a condition that involves an increase in the number of platelets (small blood cells involved in blood clotting). In patients with thrombocythemia, the bone marrow produces more megakaryocytes (cells that become platelets) than normal. The clinical manifestations of this disease include gastrointestinal tract bleeding, arterial or venous thrombosis (formation of blood clots), problems with blood circulation in the fingers and toes, stroke, and heart attack. Also, cases of gout and peptic ulcer have been reported in patients with thrombocythemia. This disease usually occurs in people in their thirties and forties. In an attempt to identify the clinical features and manifestations associated with thrombocythemia, the case records of 268 patients attending the Mayo Clinic between 1975 and 1989 were reviewed. Twenty-two percent of the patients had a related skin condition (cutaneous manifestation). The most common skin conditions involved the presence of a purplish discoloration of the skin caused by bleeding into the tissue or by blood clots, and erythromelalgia (reddening and burning pain in the feet or hands). Other types of skin lesions and manifestations that were associated with thrombocythemia included ulcers of the legs and toes, gangrene (tissue death), livedo reticularis (purple discoloration of the skin), thrombophlebitis (inflammation of a vein with blood clotting), itching, and Raynaud's phenomenon (white or blue discoloration of the fingers caused by blood vessel constriction in response to cold or emotion). These results indicate that thrombocythemia is related to a wide variety of skin disorders. In many cases, the presence of one of the skin disorders mentioned above provided the basis for a diagnosis of thrombocythemia. It is important to diagnose cases of thrombocythemia because of the dangerous vascular events, such as hemorrhage and stroke, that can result. (Consumer Summary produced by Reliance Medical Information, Inc.)