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Management of Lymphomas: A Case-Based Approach pp 157–172Cite as

Cutaneous T-cell lymphoma

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Abstract

An 83-year-old female presented with a progressing pruritic cutaneous rash that started 8 years ago. On clinical exam there were numerous coalescing, infiltrated, scaly, and partially crusted erythematous plaques distributed over her trunk and extremities and a large fungating ulcerated nodule on her right thigh covering 75% of her total body surface area (Figure 10.1). Lymphoma-associated alopecia and a left axillary lymphadenopathy were also noted. For the past 3–4 months she reported fatigue, severe pruritus, night sweats, 20 pounds of weight loss, and loss of appetite. She was diagnosed with mycosis fungoides (cutaneous patches and plaques) 4 years ago per skin biopsy. Work-up included computed tomography (CT) scans and laboratory tests such as flow cytometry for Sézary cells that were all negative for systemic involvement. She was initially treated with psoralen and UV-A phototherapy (PUVA) thrice weekly and/or topical rexinoid inhibitor (bexarotene 1% gel) daily for about 2 years, but discontinued due to development of cutaneous ulcerated tumors and lymphadenopathy. Subsequent regimens included vorinostat and prednisone. She developed intractable pruritus and worsening skin rash for the past 3 months for which she was recently started on topical nitrogen mustard 0.016% gel and oral prednisone (20 mg). Her past clinical history is remarkable for lung adenocarcinoma treated with partial lobectomy plus paratracheal lymph node resection, hypertension, smoking, and chronic obstructive pulmonary disease requiring oxygen.

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Authors and Affiliations

  1. Duarte, USA

    Belen Rubio Gonzalez, Steven T. Rosen & Christiane Querfeld

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  1. Belen Rubio Gonzalez
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  2. Steven T. Rosen
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  3. Christiane Querfeld
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Editor information

Editors and Affiliations

  1. City of Hope Hospital, Duarte, California, USA

    Jasmine Zain

  2. Toni Stephenson Lymphoma Center, City of Hope Hospital, Duarte, California, USA

    Larry W. Kwak

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Gonzalez, B.R., Rosen, S.T., Querfeld, C. (2017). Cutaneous T-cell lymphoma. In: Zain, J., Kwak, L. (eds) Management of Lymphomas: A Case-Based Approach. Adis, Cham. https://doi.org/10.1007/978-3-319-26827-9_10

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  • DOI: https://doi.org/10.1007/978-3-319-26827-9_10

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  • Publisher Name: Adis, Cham

  • Print ISBN: 978-3-319-26825-5

  • Online ISBN: 978-3-319-26827-9

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