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Neoplastic erythema nodosum

L Y Matsuoka1

  • 1Department of Dermatology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA.

Journal of the American Academy of Dermatology
|February 1, 1995
PubMed
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Erythema nodosum (EN) can be caused by direct skin invasion from B-cell lymphoma. Treating the lymphoma led to the simultaneous resolution of both EN and the B-cell lymphoma.

Area of Science:

  • Dermatology
  • Hematology
  • Oncology

Background:

  • Erythema nodosum (EN) is an inflammatory condition typically presenting as tender, red nodules on the lower legs.
  • Systemic lymphomas can manifest with various cutaneous findings, but direct infiltration of EN lesions is rarely documented.

Observation:

  • Immunohistologic examination of an EN lesion revealed infiltration by atypical lymphocytes.
  • These atypical lymphocytes formed a monoclonal population of B cells expressing lambda light chains.
  • Similar B-cell populations were identified in the patient's peripheral blood via flow cytometry.

Findings:

  • The study identified erythema nodosum as a direct cutaneous manifestation of B-cell lymphoma.
  • Chemotherapy targeting the systemic B-cell lymphoma resulted in the concurrent resolution of both the lymphoma and the EN lesions.

Related Experiment Videos

  • This represents the first documented case of EN caused by direct cutaneous invasion of B-cell lymphoma.

    • Implications:

    • This finding expands the differential diagnosis for erythema nodosum, particularly in patients with a history of or suspicion for lymphoma.
    • It highlights the importance of considering hematologic malignancies in the workup of refractory or atypical EN presentations.
    • The direct link suggests that targeted lymphoma therapy may effectively treat associated EN lesions.