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Fatal Cytotoxic Cutaneous Lymphoma Presenting as Ulcerative Psoriasis
Roger H. Weenig, MD;
Nneka I. Comfere, MD;
Lawrence E. Gibson, MD;
Javier Alonso-Llamazares, MD, PhD;
Mark D. P. Davis, MD;
Mark R. Pittelkow, MD;
Rokea A. el-Azhary, MD, PhD
Arch Dermatol. 2009;145(7):801-808.
Background Psoriasis is a common, nonulcerative skin disorder.
Observations We describe 3 men recently referred to our institution for evaluation and treatment of severe, ulcerative psoriasis that ultimately was determined to be aggressive, cytotoxic, cutaneous lymphoma. Each had a history of relatively indolent, nonulcerative patches and plaques (duration, 2-45 years) that changed to ulcerated lesions; these rapidly progressed and eventuated in death.
Conclusions The clinical characteristics of the skin lesions and the histopathologic findings form a distinct and rare presentation of cutaneous lymphoma. The initial course is similar to that of mycosis fungoides but eventuates in a highly aggressive disease with fatal outcome.
Author Affiliations: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
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