Pyoderma Gangrenosum and Leukemia

To the Editor.— The excellent article by Drs. Perry and Winkelmann on bullous pyoderma gangrenosum and leukemia in theArchives(106:901, 1972) prompts us to report a case of ours. In this case, there has been recent development of pyoderma gangrenosum while the patient was receiving treatment for acute lymphoblastic leukemia. The lesions, which were resistant to most drugs, eventually cleared up with administration of rifampin. Report of a Case A 13-year-old Chinese schoolgirl was found to have acute lymphoblastic leukemia in September 1971. She was anemic, but was otherwise well. There was a hepatomegaly of 3 cm below the right costal margin. The other organs were not enlarged. Hematologic studies showed the following results: total red blood cell count, 3 million/cu mm; hemoglobin, 9.0 gm/100 ml; total leukocyte count, 26,700/ cu mm, with 63% blast cells, 31% lymphocytes, and 6% neutrophils; platelet count, 20,000/cu mm; reticulocyte count, 2%; packed