Ichthyosis: A Harbinger of Lymphoma

Description

A 60-year-old, previously healthy woman presented with patchy skin colour change and dryness for 3 months duration. She also gave a history of recurrent boils requiring local and oral antibiotics. On examination, patchy hyperpigmented skin with scaly appearance was apparent along with features of healed and active infection (figure 1). She also had multiple, firm, lymph nodes (largest 2 cm) in the bilateral axillae. On evaluation, haemoglobin was 115 g/L, white blood cells 7.8x10⁹/L, platelets 248x10⁹/L; peripheral blood smear was normal. Representative skin biopsy showed loss of granular layer characteristic of ichthyosis (figure 2). Right axillary lymph node excision biopsy and immunohistochemistry confirmed the diagnosis of T-cell non-Hodgkin's lymphoma (not otherwise specified). HIV ELISA, thyroid function tests and coeliac serology were inconclusive. She was treated with cyclophosphamide, doxorubicin, vincristine  and prednisolone chemotherapy along with moisturisers (urea-based), regular skin cleansing and salty water bath. After six cycles...

https://ift.tt/2qmMutD