Marginal zone lymphoma with severe rashes: A case report.

Area of Science:

• Hematology
• Oncology
• Dermatology

Background:

• Marginal zone lymphoma (MZL) is an indolent non-Hodgkin lymphoma (NHL).
• MZL can present with severe skin manifestations.
• Rashes are a rare initial symptom of MZL.

Observation:

• A case of MZL presented with generalized skin rashes, pruritus, and purulent discharge.
• Initial treatment with rituximab and zanubrutinib was ineffective.
• Switching to obinutuzumab and zanubrutinib led to symptom alleviation.

Findings:

• Obinutuzumab, a type II anti-CD20 monoclonal antibody, combined with zanubrutinib, resolved severe skin rashes in an advanced MZL case.
• Type I anti-CD20 mAb combination therapy showed poor efficacy.
• Type II anti-CD20 mAb combination therapy demonstrated clinical benefit.

Implications:

• Switching to a type II anti-CD20 mAb combination regimen may be a viable strategy for advanced MZL refractory to type I therapy.
• This case suggests a potential new treatment avenue for difficult-to-treat MZL.
• Further investigation into type II anti-CD20 mAbs for MZL is warranted.