{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T02:39:17Z","timestamp":1789007957612,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,10,26]],"date-time":"2012-10-26T00:00:00Z","timestamp":1351209600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>An insect\u2010bite\u2010like reaction is known to occur in patients with chronic lymphocytic leukemia (<jats:styled-content style=\"fixed-case\">CLL<\/jats:styled-content>). Most of the literature, however, consists of isolated case reports or small case series. The aim of this retrospective study was to review the national experience with insect\u2010bite\u2010like reaction in a large group of patients with <jats:styled-content style=\"fixed-case\">CLL<\/jats:styled-content>. The study cohort of patients with these skin reactions consisted of 48 patients (25 males, 23 females) of mean age 64.8\u00a0yr (range 33\u201389) at skin eruption. Data on clinical, histologic, immunophenotypic, and cytogenetic characteristics, treatment, and outcome were collected from the medical files. Mean time between diagnosis of <jats:styled-content style=\"fixed-case\">CLL<\/jats:styled-content> and appearance of the skin lesions was 3.1\u00a0yr (range \u22124 to 14\u00a0yr). The eruption was not related to disease activity or the course of the hematological disease. The eruption preceded the diagnosis of <jats:styled-content style=\"fixed-case\">CLL<\/jats:styled-content> in 10 patients (by 0\u20134\u00a0yr); and followed the diagnosis in 36; in 11 patients, it occurred during therapy for <jats:styled-content style=\"fixed-case\">CLL<\/jats:styled-content> and in nine after therapy. Mean duration of the skin findings was 21.5\u00a0months (range 0.3\u2013132). The eruption usually presented in summer, although it occurred also at other times of the year, and predominantly affected the upper and lower limbs, although it also appeared on unexposed areas. Treatment included local ointments, antihistaminics, oral steroids, antibiotics, phototherapy, and dapsone with varying responses. Insect\u2010bite\u2010like reactions is a relatively common and disturbing skin reaction in <jats:styled-content style=\"fixed-case\">CLL<\/jats:styled-content> patients, it may be related to the immune dysregulation accompanying <jats:styled-content style=\"fixed-case\">CLL<\/jats:styled-content> and further exacerbated by external factors, including actual insect bites, chemoimmunotherapy, and pyogenic infection.<\/jats:p>","DOI":"10.1111\/ejh.12015","type":"journal-article","created":{"date-parts":[[2012,10,3]],"date-time":"2012-10-03T08:03:11Z","timestamp":1349251391000},"page":"491-496","source":"Crossref","is-referenced-by-count":46,"title":["Insect\u2010bite\u2010like reaction in patients with chronic lymphocytic leukemia: a study from the <scp>I<\/scp>sraeli <scp>C<\/scp>hronic <scp>L<\/scp>ymphocytic <scp>L<\/scp>eukemia <scp>S<\/scp>tudy <scp>G<\/scp>roup"],"prefix":"10.1111","volume":"89","author":[{"given":"Osnat","family":"Bairey","sequence":"first","affiliation":[{"name":"Hematology Institute Rabin Medical Center, Beilinson Hospital Petach Tikva Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neta","family":"Goldschmidt","sequence":"additional","affiliation":[{"name":"Hematology Institute Hadassah Medical Center Jerusalem Israel"},{"name":"Faculty of Medicine Hebrew University Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Ruchlemer","sequence":"additional","affiliation":[{"name":"Hematology Institute Shaare Zedek Medical Center Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar","family":"Tadmor","sequence":"additional","affiliation":[{"name":"Hematology Institute Bnai\u2010Zion Medical Center Haifa Israel"},{"name":"Faculty of Medicine Technion University Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neomi","family":"Rahimi\u2010Levene","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"Blood Bank and Hematology Institute Assaf Harofeh Medical Center Zerifin Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Yuklea","sequence":"additional","affiliation":[{"name":"Hematology Institute Meir Medical Center Kfar Saba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lev","family":"Shvidel","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Hebrew University Jerusalem Israel"},{"name":"Hematology Institute Kaplan Medical Center Rehovot Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Berrebi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Hebrew University Jerusalem Israel"},{"name":"Hematology Institute Kaplan Medical Center Rehovot Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Polliack","sequence":"additional","affiliation":[{"name":"Hematology Institute Hadassah Medical Center Jerusalem Israel"},{"name":"Faculty of Medicine Hebrew University Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yair","family":"Herishanu","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"Hematology Institute Tel Aviv Sourasky Medical Center Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Israeli Chronic Lymphocytic Leukemia Study Group (ICLLSG)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,10,26]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"814","article-title":"Skin 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