alexa A Rare Presentation of Cutaneous Pseudolymphoma as a Preleukaemic State
ISSN: 2329-6917

Journal of Leukemia
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Case Report

A Rare Presentation of Cutaneous Pseudolymphoma as a Preleukaemic State

Muthu Sivaramakrishnan 1*, Ronald Kerr2, Alan Evans3 and Andrew Affleck1

1Department of Dermatology, Ninewells Hospital and Medical School, Dundee, UK

2Department of Haematology, Ninewells Hospital and Medical School, Dundee, UK

3Department of Histopathology, Ninewells Hospital and Medical School, Dundee, UK

*Corresponding Author:
Muthu Sivaramakrishnan
Specialist Registrar
Department of Dermatology
Ninewells Hospital and Medical School
Dundee, DD19SY, UK
E-mail: [email protected]

Received date Jul 30, 2013; Accepted date October 01, 2013; Published date October 03, 2013

Citation: Sivaramakrishnan M, Kerr R, Evans A, Affleck A (2013) A Rare Presentation of Cutaneous Pseudolymphoma as a Preleukaemic State. J Leuk (Los Angel) 1:122. doi: 10.4172/2329-6917.1000122

Copyright: © 2013 Sivaramakrishnan M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

A patient presented with progressive and unresponsive erythematous rash affecting his trunk and limbs over a period of 5 years. His systemic examination and extensive relevant investigations were normal throughout this period. Skin biopsies at different times showed features of annular erythema, cutaneous pseudolymphoma and sub-acute dermatitis. Five years after the initial presentation, he developed erythroderma, leonine facies, lymphadenopathy and peripheral lymphocytosis. CT chest and abdomen revealed generalised lymphadenopathy. Skin biopsy and immunophenotyping was suggestive of Sezary syndrome. However, peripheral blood smear examination was highly suggestive of T-cell prolymphocytic leukaemia (TPLL). Subsequent molecular genetic analysis was consistent with TPLL. To the best of our knowledge, there are no reports of cutaneous pseudolymphoma transforming to TPLL in the literature. The long indolent course of apparently benign skin disease before transforming into TPLL appears to be unique in our case. An analogy can be made with cutaneous T-Cell lymphoma both in terms of the difficulty in proving the diagnosis-needing multiple skin biopsies, and in the possible link between cutaneous and systemic disease. TPLL should be considered as a rare cause of erythroderma, which may clinically and histologically mimic Sezary syndrome.

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