Indian Journal of Dermatology
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Year : 2015  |  Volume : 60  |  Issue : 4  |  Page : 422

A dramatic presentation of an unusual form of cutaneous lymphoma

1 Department of Medicine, National University Hospital, Singapore
2 Department of Pathology, National University Hospital, Singapore

Correspondence Address:
Dr. Derrick Chen-Wee Aw
Division of Dermatology, National University Hospital, 5 Lower Kent Ridge Road, S119074
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-5154.160532

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We report an unusual and dramatic presentation of a rare form of cutaneous lymphoma, known as subcutaneous panniculitis-like T-cell lymphoma (SPTCL). This patient presented with a pruritic, florid and purpuric rash that was diagnosed as lobular panniculitis and treated with oral steroids for 1 year with no success. His skin lesions would return each time oral corticosteroids were being weaned off. Upon presentation to our clinic, repeated deep skin biopsies with immunohistochemical analysis coupled with the clinical history of persistent B symptoms and the presence of pancytopenia helped clinched the rare diagnosis of SPTCL with hemophagocytosis. The patient was then started on cyclosporine and dexamethasone before definitive chemotherapy. This rare and diagnostically challenging condition is commonly misdiagnosed as benign panniculitis or eczema, and highlights the importance of repeated skin biopsies.

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