Diffuse Hyperkeratotic Skin Lesion as Paraneoplastic Manifestation of Classical Hodgkin's Lymphoma

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Diffuse Hyperkeratotic Skin Lesion as Paraneoplastic Manifestation of Classical Hodgkin's Lymphoma

Vishnu Sharma ¹
Abhinav Agarwal ²
Vansh Bagrodia ^2*

1.Department of Clinical Hematology, SMS Medical College, Jaipur, Rajasthan, India.

2.Final year MBBS student at SMS Medical College, Jaipur, Rajasthan, India.

*Corresponding Author: Vansh Bagrodia, Final year MBBS student at SMS Medical College, Jaipur, Rajasthan, India.

Citation: Sharma V, Agarwal A, Bagrodia V. (2024). Diffuse Hyperkeratotic Skin Lesion as Paraneoplastic Manifestation of Classical Hodgkin's Lymphoma, Clinical Research and Reports, BioRes Scientia Publishers. 1(2):1-2. DOI: 10.59657/2995-6064.brs.24.016

Copyright: © 2024 Vansh Bagrodia, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: October 13, 2023 | Accepted: October 26, 2023 | Published: January 12, 2024

Abstract

Keywords: lymphadenopathy; hyperkeratotic; manifestation; non-erythematous; fever

Case

A 28-year-old male presented with a two-month history of fever and generalized lymphadenopathy. Notably, he had a six-month history of pruritic, scaly, hyperkeratotic, non-erythematous skin lesions spread diffusely over his trunk and the back of his head, covering 41.5% of his body surface area (Figures 1 and 2). The patient reported transient improvement when started on steroids by a dermatologist, but the lesions recurred after two months of treatment and have persisted since.

Lymph node biopsy and immunohistochemistry confirmed a diagnosis of Classical Hodgkin lymphoma (nodular sclerosis type), stage 3B (as indicated by PET-CT). The patient commenced ABVD (Adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy.

Skin involvement in Hodgkin’s lymphoma typically presents as non-specific lesions, such as generalized pruritus, hyperpigmentation, eczema, or acquired ichthyosis. These lesions are often paraneoplastic and are usually observed just prior to or at the time of the diagnosis of advanced Hodgkin lymphoma associated with systemic nodal disease [1,2].

While paraneoplastic syndromes are relatively common in lymphoma patients, such extensive skin involvement across the trunk and head is a noteworthy occurrence [3].

Figure 1: Skin lesions diffusely spread over whole trunk.

Figure 2: Skin lesions diffusely spread over back of head.

References

Dr Selene Ting, Medical Registrar, Whangarei Hospital, New Zealand. DermNet NZ Editor in Chief: Adjunct A/Prof Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand.
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Graus F, Ariño H, Dalmau J. (2014). Paraneoplastic neurological syndromes in Hodgkin and non-Hodgkin lymphomas. Blood, 123(21):3230-3238.
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Hsia, C. C, Howson-Jan, K., &Rizkalla, K. S. (2009). Hodgkin lymphoma with cutaneous involvement. Dermatology Online Journal, 15(5).
Publisher | Google Scholor

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