Paraneoplastic Erythema Nodosum as a Prelude to Hodgkin Lymphoma

Erythema nodosum is currently thought to represent a delayed hypersensitivity reac- tion to deposition of circulating immune complexes, followed by neutrophilic infiltration of the septa in the subcutaneous tissue. We describe a patient with advanced Hodgkin lymphoma with B symptoms, preceded by erythema nodosum of the left shin by 12 weeks. This dermatologic entity cleared after the treatment for Hodgkin lymphoma, suggesting a true paraneoplastic reaction. Given its known temporal association with Hodgkin lymphoma, we believe that this link deserves more exploration in both re- search laboratories and clinical practice.