Annual skin cancer exam leads to leukemia diagnosis
A dermatologist discovers deep bruising during a routine skin cancer exam, leading to a leukemia diagnosis.
I’m fair-skinned and live in Phoenix, so an annual skin check is a part of my routine. At the end of 2015, I was completing all of my end-of-year exams, including a skin cancer exam with my dermatologist, Dr. Lindsay Ackerman. In an effort to improve my health, I’d also been going to the gym regularly and lifting weights. At my annual exam, Dr. Ackerman noticed dark bruises on my upper thighs and abdomen. I thought they were from a particularly strenuous workout a few days earlier, but Dr. Ackerman thought otherwise. She was concerned about my blood’s ability to clot and ordered a blood test for me and promised to call as soon as she had results.
The next morning she told me that she thought there was a serious problem because of my blood test results. She told me she was going to consult with a colleague in oncology, Dr. David Paul. I was confused because I had made such an effort to be healthier over the past year and was feeling well — and deeply concerned at the thought of needing an oncologist.
She referred me to Dr. Paul, a hematology-oncology specialist, to have further tests done. Dr. Ackerman provided Dr. Paul with background and he ordered further tests to assess my blood and bone marrow. I was diagnosed with myelofibrosis, a rare type of chronic leukemia that disrupts the body’s normal production of blood cells and can result in easy bruising.
I required a bone marrow transplant, and fortunately, my brother was able to be my donor. I consider myself lucky to have the network of doctors I do. It all started with Dr. Ackerman. Truly to this day, she saved my life.
The dermatologist's perspective
“When I saw the bruising on John, I was concerned he had a problem with his ability to clot his blood appropriately, because the distribution of his bruising was not typical for trauma. I ordered a blood test to assist with further evaluation. While bruising can be common when it appears in unusual areas or in the absence of trauma, it can represent problems with other organ systems. The blood test confirmed that this was a sign of a serious medical issue and I enlisted my colleague Dr. Paul for evaluation. I’m grateful for the specialists with whom we work. Dr. Paul and I have shared several patients over many years. I was simply able to pick up the phone and ask for help.”
─ Lindsay S. Ackerman, MD Dermatologist, Medical Dermatology Specialists
The hematologist's perspective
“I first met Dr. Ackerman when she was a medical student, and she was assigned to my oncology clinic. After she became a board-certified dermatologist, we remained in touch. We collaborate frequently on patient cases and she provides dermatology consults for me at our shared hospital. I’m grateful she acted swiftly when she noticed John’s bruising. Because of her quick thinking, we were able to provide the care John needed before his condition worsened.”
─ David M. Paul, MD, Hematologist-Oncologist, Palo Verde Cancer Center