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Erythrodermic Psoriasis With Anasarca and Lymphadenopathy Mimicking Lymphoma
Noren Din1,2
1Internal Medicine, MultiCare Allenmore Hospital, Tacoma, USA.
Abstract:
A 25-year-old man with chronic psoriasis presented with progressive erythroderma, anasarca with a reported 30-lb weight gain, and bulky lymphadenopathy, raising concern for lymphoma. Lymph node biopsy showed dermatopathic lymphadenopathy, and expert review of skin specimens favored an inflammatory process over cutaneous T-cell lymphoma. Low-dose methotrexate was started, followed by patient-reported improvement in function, edema, and skin changes. This case emphasizes recognizing severe inflammatory skin disease as a possible contributor to systemic illness and correlating the clinical presentation with pathology. Improvement after methotrexate supports clinical benefit but is not diagnostic of psoriasis.
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