Cutaneous response to BMS-354825. (A) Skin biopsy shows cutaneous involvement by precursor B cells; neoplastic cells diffusely infiltrate the dermis. Hematoxylin-eosin staining. Low magnification, × 10. At immunohistochemistry, the lymphoblasts express B-cell markers as CD79a, precursor B-cell marker CD10-CALLA, and show nuclear staining for TdT. Images were obtained with a Nikon Eclipse E600 microscope (Nikon, Tokyo, Japan) with 10 ×/0.25 NA and 40 ×/0.65 NA brightfield objectives, acquired with a JVC TK 1270 color video camera (JVC, Tokyo, Japan), and AVer E-Z Capture software (AVerMedia, Milpitas, CA). Images were processed with Paint Shop Pro 7.0 (Jase Software, Eden Prairie, MN). CD79a, CALLA, and TdT are from Dako (Glostrup, Denmark). (B) Patient with cutaneous infiltrate of acute lymphoblastic leukemia resistant to previous treatments. In panel Bi, presence of multiple dermohypodermal nodules with a central ulceration pre–BMS-354825 therapy. In panels Bii-iii the same lesion 1 and 2 weeks after starting therapy. Four weeks after treatment, the scalp lesion was completely healed with only the presence of a hypopigmentated scar (Biv). Pictures were taken using a Panasonic Lumix 2MC-FX5 (Panasonic, Osaka, Japan) digital camera and processed with Paint Shop Pro 7.0.