Palisaded Neutrophilic and Granulomatous Dermatitis Associated With ASXL1-Mutated Chronic Myelomonocytic Leukemia: A Case Report and Literature Review

Abstract: Palisaded neutrophilic and granulomatous dermatitis (PNGD) is a relatively rare histopathologic reaction pattern that has been associated with several underlying conditions including rheumatoid arthritis, connective tissue disorders, certain drugs, and hematologic malignancies, particularly chronic myelomonocytic leukemia (CMML). CMML shows features of a myeloproliferative neoplasm and myelodysplastic syndrome. The diagnosis can be supported by identifying an acquired clonal molecular abnormality, most commonly involving TET2, SRSF2, ASXL1, RUNX1, NRAS , or CBL . Rare previous reports have highlighted the association between PNGD and SRSF2 -mutated CMML. In this study, we report the first known case of PNGD-associated ASXL1 -mutated CMML without a coexistent SRSF2 variant.