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Fulminant Cutaneous Eruption in a 51-Year-Old Man—Diagnosis
Arch Dermatol. 2007;143(2):255-260.
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Diagnosis: Primary cutaneous anaplastic large cell lymphoma (C-ALCL).
MICROSCOPIC FINDINGS AND CLINICAL COURSE
Biopsy specimens from the chest and right thigh revealed an atypical lymphoid infiltrate, which was associated with occasional necrotic keratinocytes and prominent hemorrhage. Markedly atypical mononuclear cells were observed within the epidermis and papillary dermis and extended well into the reticular dermis in an interstitial pattern. The cells were positive for CD3 and CD30 and negative for CD20 and CD56. The findings of direct immunofluorescence of skin samples were not diagnostic of a primary blistering disorder.
A computed tomographic scan was negative for extracutaneous disease. Two days after presentation, the patient was transferred to the burn unit because of 90% body surface involvement. His condition initially improved on a regimen of methotrexate and prednisone. The methotrexate therapy was discontinued after the patient developed acute renal failure due to dehydration. A second set of skin biopsy specimens obtained 2 months later were negative for CD30 cells. The patient's course was complicated . . . [Full Text of this Article] DISCUSSION
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Arch Dermatol. 2007;143(2):255-260.
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