Unusual presentation of T-cell lymphoma

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• Cutaneous T-cell lymphoma (CTCL) is a diverse group of malignant T-cell disorders primarily affecting the skin.
• Erythema multiforme (EM)-like presentations can be a rare manifestation of various conditions, including hematologic malignancies.
• Early and accurate diagnosis of CTCL is crucial for effective management and improved patient outcomes.

Purpose of the Study:

• To report a case of a 56-year-old woman with an unusual presentation mimicking erythema multiforme.
• To highlight the diagnostic challenge posed by atypical skin lesions in the context of potential underlying malignancy.
• To emphasize the importance of skin biopsy in diagnosing plaque-stage cutaneous T-cell lymphoma.

Main Methods:

• Clinical presentation of a 56-year-old female patient with a one-month history of papules, plaques, and erythema multiforme-like lesions.
• Detailed description of the distribution and morphology of skin lesions, including painful necrotizing ulcers and oro-genital ulcerations.
• Histopathological examination of skin biopsy specimens to evaluate for neoplastic infiltration.

Main Results:

• The patient exhibited widespread papules, plaques, and erythema multiforme-like lesions on palms, soles, abdomen, back, and folds.
• Painful necrotizing ulcers and oro-genital ulcerations were noted.
• Skin biopsy findings were suggestive of the plaque stage of cutaneous T-cell lymphoma.

Conclusions:

• This case underscores the varied clinical spectrum of cutaneous T-cell lymphoma.
• Atypical presentations, such as erythema multiforme-like lesions, necessitate thorough dermatopathological investigation.
• Prompt diagnosis of plaque-stage CTCL is essential for appropriate therapeutic intervention.