Abstract REPORT OF A CASE A 43-year-old black woman presented with a 2-month history of pruritus and a skin eruption that began as papules on her chest. She denied any constitutional symptoms, and a review of symptoms proved noncontributory. Physical examination revealed a 9×11-cm ulcer with undermined margins on the anterior aspect of the left side of her chest (Figure 1 ). There were scattered papules and nodules surrounding the large ulcerated area. No vesicles were seen. Fistulous tracts were noted in the area of the left posterior cervical lymph node chain. It appeared that the ulceration originated from enlarged nodes. The results of viral and bacterial cultures were negative. No clinical response to both antiviral and antibacterial therapies was appreciated. A dermatology consultation was requested, and an incisional biopsy was performed at the leading edge of the ulcer. The histologic features of the biopsy specimen are shown in Figure 2.What References 1. Hutchinson JH. Adenoid (Hodgkin's) disease . Med Surg Rep. 1875;32:127. 2. Arroyo A, Sanchez J, Velez-Garcia E. Cutaneous manifestations of Hodgkin's disease . Cutis. 1983;32:79-82. 3. Bluefarb SM. Cutaneous Manifestations of the Malignant Lymphomas . Springfield, Ill: Charles C Thomas Publisher; 1960:240. 4. Tassies D, Sierra J, Montserrat E, Marti R, Estrach T, Rozman C. Specific cutaneous involvement in Hodgkin's disease . Hematol Oncol. 1992;10:75-79.Crossref 5. Smith JL, Butler JJ. Skin involvement in Hodgkin's disease . Cancer. 1980;45: 354-361.Crossref 6. Benninghoff DL, Medina A, Alexander LL, Camiel MR. The mode of spread of Hodgkin's disease to the skin . Cancer. 1970;26:1135-1140.Crossref 7. Patterson JW. Lymphomas . Dermatol Clin. 1992;10:235-251. 8. White RM, Patterson JW. Cutaneous involvement in Hodgkin's disease . Cancer. 1985;55:1136-1145.Crossref 9. Davies AN, Dobbs HJ. Isolated cutaneous relapse in Hodgkin's disease: a case report and review of the literature . Clin Oncol. 1993;5:120-121.Crossref 10. Silverman CC, Strayer DS, Wasserman MD. Cutaneous Hodgkin's disease . Arch Dermatol. 1982;118:918-921.Crossref 11. Kadin ME. Lymphomatoid papulosis, Ki-1+ lymphoma, and primary cutaneous Hodgkin's disease . Semin Dermatol. 1991;10:164-171. 12. Sioutos N, Kerl H, Murphy SB, Kadin ME. Primary cutaneous Hodgkin's disease . Am J Dermatopathol. 1994;16:2-8.Crossref 13. Frizzera G. The distinction of Hodgkin's disease from anaplastic large cell lymphoma . Semin Diagn Pathol. 1992;9:291-296.
Archives of Dermatology – American Medical Association
Published: Nov 1, 1997
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