A patient with a malignant lymphoproliferative disorder may show skin reactions that look like insect bites or may develop an excessive reaction to an insect bite.
Hypersensitivity reaction to mosquito bites involves the presence of:
(1) intense skin reactions at the site of mosquito bites, with erythema, bullae and/or ulceration.
(2) fever
(3) malaise
Insect bite-like reaction may occur after an actual insect bite or may resemble an insect bite. These show:
(1) erythema
(2) vesicles or bullae
(3) wheals
(4) ulceration
Some patients may develop an eosinophilic cellulitis at the site (Wells' syndrome).
Malignant lymphoproliferative disorders associated with these reactions include:
(1) non-Hodgkin's B cell lymphoma (especially mantle cell lymphoma)
(2) NK cell leukemia or lymphoma
(3) CLL
(4) ALL or AML
(5) Epstein-Barr related lymphoproliferative disorders
Differential diagnosis:
(1) bacterial cellulitis
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