A case of erythema elevatum diutinum associated with B-cell lymphoma: a rare distribution involving palms, soles and nails

Abstract

We report a case of erythema elevatum diutinum (EED) in association with malignant B-cell lymphoma. A 62-year-old man developed EED with an unusual distribution involving the palms, soles and nails. Treatment with dapsone was effective for his skin and nails until he developed generalized lymphadenopathy which turned out to be malignant lymphoma. Many haematological diseases, e.g. IgA paraproteinaemia and myeloma, have been reported in association with EED, but not malignant lymphoma. Even though it may just be a coincidence, we would like to add malignant lymphoma as one of the diseases associated with EED because the activity of EED and malignant lymphoma fluctuated in parallel.

Erythema elevatum diutinum: a review of presentation and treatment

“…Methotrexate was used in one case, with an initial response followed by regression . Surgical excision was successful in one patient who was unable to tolerate oral medications . Intra‐lesional corticosteroids and surgical excision are only recommended in localized disease .…”

Erythema elevatum diutinum with rare distribution as a first clinical sign of non‐Hodgkin's lymphoma: A novel association?

“…This is just the second case of EED associated with malignant lymphoma 9 and the first associated with IgM λ monoclonal gammopathy and non‐Hodgkin's lymphoma.…”

“…The first case of EED associated with malignant lymphoma was described in 2000 and was a B‐cell follicular lymphoma 9 . EED had a rare distribution regarding palms and soles.…”

“…EED has been reported in association with recurrent bacterial infections, 3 immunoglobulin (Ig)A paraproteinaemia 4,5 myeloma, 6 cryoglobulinemia, rheumatoid arthritis, Crohn disease, Wegener's granulomatosis 7 and recently with HIV infection 8 . However, this is just the second case of EED associated with malignant lymphoma 9 and the first associated with IgM monoclonal gammopathy.…”

Manifestations dermatologiques des gammapathies monoclonales : apport de l’histopathologie cutanée

“…Plus tard, une fibrose s'installe, ponctuée de quelques polynucléaires neutrophiles et parfois de dépôts d'hémosidérine. Dans quelques cas, les lésions s'associent à une réaction macrophagique faite de cellules riches en graisses (xanthomisées), pouvant s'associer à des dépôts lipidiques extracellulaires [60][61][62].…”