a case of hypertrichosis lanuginosa acquisita associated with non
Transcription
a case of hypertrichosis lanuginosa acquisita associated with non
A CASE OF HYPERTRICHOSIS LANUGINOSA ACQUISITA ASSOCIATED WITH NON-HODGKIN LYMPHOMA Mehdi Iskandarli, MD, Can Ceylan, MD. Ege University Faculty of Medicine Dermatology and Venereology Department Izmir, Turkey INTRODUCTION Hypertrichosis lanuginosa aqcuisita (HLA) is a malignancy associated paraneoplastic dermatosis in which fine, long, nonpigmentous hairs on face are main clinical features. HLA associated with nonmalignant disorders also reported in the literature. Here we present a case of HLA, associated with systemic diffuse giant B cell lymphoma with cutaneous involvment. METHODOLOGY 44-year-old female patient who had been diagnosed as a dermatomyositis for four years, hospitalized in our department due to disseminated herpes zoster. Upon dermatological examination, fine, long, colorless hairs surrounding all face were noticed that have a history of two weeks. Also, prominent nodular lesion on lateral side of left breast was remarkable. Malignancy screening was done in internal medicine department before hospitalisation in dermatology department and negative results were obtained. Hypertrichosis on face and nodular lesions on breast were not noticed and the patient was discharged. Nodular lesions were excised and the biopsy results were reported as a diffuse giant B cell lymphoma. As a result of PET-CT scan, systemic involvment of lymphoma were detected. RESULT In detailed dermatological examination of the patient who had been hospitalized due to systemic zona zoster, HLA on face and nodular lesions on lateral part of left breast were detected. Nonmalignant causes of HLA such as HIV, hyperthyroidism, recent cyclosporine use were excluded. The nodular lesion of the patient was excised and histopathological examination was reported as a diffuse giant B cell NonHodgkin lymphoma. Lymphoma was thought to develop due to immunosuppression and skin infiltration of lymphoma accepted as indicator of severity of malignancy. So patient was transferred to hematology department for chemotherapy treatment. CONCLUSION HLA most commonly develops in females. The most frequently associated malignancy is a colon adenocarcinoma. In the present case, rarely seen HLA is thought to be associated with systemic diffuse giant B cell Non-Hodgkin lymphoma with skin infiltration, which is less frequently inducing HLA. Although the patient was followed due to systemic herpes zoster, thanks to detailed physical and dermatological examination, mortality associated two skin disease was detected. REFERENCES: 1. Slee PH, van der Waal RI, Schagen van Leeuwen JH et al. Paraneoplastic hypertrichosis lanuginosa acquisita: uncommon or overlooked? Br J Dermatol. 2007;157:1087-92. 2. Worsnop F1, Campalani E. Paraneoplastic hypertrichosis lanuginosa acquisita: a delayed presentation in quiescent chronic lymphocytic leukaemia. Clin Exp Dermatol. 2014;39669-70. 3. Jemec GB. Hypertrichosis lanuginosa acquisita. Report of a case and review of the literature. Arch Dermatol 1986; 122:805–8.
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