Pityriasis rosea-like cutaneous eruption as the presenting symptom of Hodgkin lymphoma. Case report and review of the literature.

Abstract

Background: Cutaneous involvement by Hodgkin lymphoma is extremely rare and usually follows extensive involvement of the lymph nodes. Cutaneous manifestations of Hodgkin lymphoma may be divided into specific and non-specific. Generalized pruritus is one of the most common non-specific presentations of Hodgkin lymphoma as is cutaneous granulomas. Such signs and symptoms should prompt thorough physical exam, including evaluation of lymph nodes, especially in a young patient.

Main observation: We report a case of a 22-year-old man who presented with night sweats, weight loss, dry cough, and generalized maculopapular eruption that started with a large patch in the center of the chest and spread to the extremities. Biopsy of the rash revealed pityriasis rosea-like findings. A computerized tomography scan of the chest revealed a mediastinal mass. Biopsy of the mediastinal mass revealed Reed-Sternberg cells in a fibrotic background, diagnostic of Hodgkin lymphoma, nodular sclerosis type.

Conclusion: In conclusion, the presentation of Hodgkin lymphoma as a pityriasis rosea-like cutaneous eruption is rare and clinicians should be aware of this presentation. In this paper we review the non-specific cutaneous manifestations of Hodgkin lymphoma in an effort to raise awareness of the diversity of early cutaneous signs of Hodgkin lymphoma.