Pernio. A possible association with chronic myelomonocytic leukemia

Florid pernio occurred in an elderly man with chronic myelomonocytic leukemia (CMML). Previous case reports showed four elderly men with pernio and a hematologic disorder. Retrospective examination of the reported hematologic features of these cases enabled us to identify them as cases of CMML. Pernio preceded the diagnosis of the leukemia in all cases. We suggest that pernio may occur as an initial manifestation of CMML. The pathogenesis of pernio in association with CMML remains unclear.