Clin Transl Oncol (2009) 11:552-553 DOI 10.1007/s12094-009-0402-2
C A S E R E P O RT S
Acquired ichthyosis as a paraneoplastic syndrome in Hodgkin’s disease María Carmen Riesco Martínez · Andrés J. Muñoz Martín · Pamela Zamberk Majlis · Jorge Adeva Alfonso · Pilar Sabin Domínguez · Pilar García Alfonso · Ricardo Pérez Fernández
Received: 3 February 2009 / Accepted: 21 March 2009
Abstract An 80-year-old man was admitted to hospital with low-grade fever, weight loss, asthenia and anorexia. Physical examination revealed generalised ichthyosis with palmoplantar hyperkeratosis. CT scan showed retroperitoneal and inguinal lymph node enlargement. An inguinal lymph node biopsy revealed Hodgkin’s disease (nodularsclerosing subtype). The patient received chemotherapy, showing a clear improvement of both skin lesions and lymph nodes.
multiple myeloma, breast and lung cancers [2] and Kaposi’s sarcoma [3]. Other non-malignant diseases associated with this disorder include autoimmune syndromes, endocrinologic diseases, nutritional abnormalities, infectious diseases and drug reactions (Table 1) [4]. We report a patient with acquired ichthyosis associated with Hodgkin’s disease. After the first cycle of chemotherapy the evolution of the skin lesions was clearly favourable, showing an evident relationship between ichthyosis and lymphoma.
Keywords Acquired ichthyosis · Lymphoma · Hodgkin’s disease · Paraneoplastic syndrome Case report Introduction Acquired ichthyosis is a rare condition that usually reveals malignant diseases in adults. It is most commonly associated with Hodgkin’s lymphoma [1] but may be seen with non-Hodgkin’s lymphomas, mycosis fungoide, leukaemia,
M.C. Riesco Martínez · A.J. Muñoz Martín (쾷) · J. Adeva Alfonso · P. Sabin Domínguez · P. García Alfonso · R. Pérez Fernández Servicio de Oncología Médica Hospital General Universitario Gregorio Marañón C/ Dr. Esquerdo, 46 ES-28007 Madrid, Spain e-mail:
[email protected] P. Zamberk Majlis Servicio de Dermatología Hospital General Universitario Gregorio Marañón Madrid, Spain
An 80-year-old man with a medical history of hypertensive cardiopathy was referred to our centre with a 6-month history of asthenia, anorexia, weight loss, low-grade fever and profuse night sweating. The patient described recurrent episodes of itchy and scaly lesions involving his limbs that improved with either topical or systemic corticosteroids over many years. In the last few months, he had developed a constitutional syndrome and a progressive worsening of his cutaneous lesions that did not respond to topical corticosteroids and emollients. At the emergency room, the patient showed erythematous and scaly lesions involving his face, neck, groins and axillae. These lesions extended to the inner surface of his limbs. The skin was infiltrated and the scales were polygonal in shape. At the scrotum and penis marked oedema was observed. The soles of the feet showed areas of prominent hyperkeratosis. No other relevant signs were found at physical examination. Laboratory work-up yielded the following results: haemoglobin 9.3 g/dl, white blood cells 12,500/µl with 85% neutrophils, and platelets 647,000/µl. Renal function, serum transaminase levels, electrolytes and thyroid hormones were normal. Serum lactic dehydrogenase was 255 UI/l (normal range 135–225), albumin 2.9 g/l and beta-2microglobulin 4.4 mg/l (normal range 1.0–3.2 mg/l). Other relevant findings were: C-reactive protein 23 mg/l (normal
