Rapid Progression of Red Itchy Rash, Diagnostic Dilemma

Cutaneous T-cell lymphoma (CTCL) is an uncommon type of cancer that begins in white blood cells called T lymphocytes (T cells). Normally, T cells help body's immune system to fight off infection but, in CTCL, these cells develop abnormalities that make them attack the skin. It comprises hetero...

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Main Authors: Uma Keyal, Gopi Aryal, Sanju Babu Shrestha, Anil Kumar Bhatta
Format: Article
Language:English
Published: Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON) 2023-03-01
Series:Nepal Journal of Dermatology, Venereology & Leprology
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Online Access:https://www.nepjol.info/index.php/NJDVL/article/view/52161
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author Uma Keyal
Gopi Aryal
Sanju Babu Shrestha
Anil Kumar Bhatta
author_facet Uma Keyal
Gopi Aryal
Sanju Babu Shrestha
Anil Kumar Bhatta
author_sort Uma Keyal
collection DOAJ
description Cutaneous T-cell lymphoma (CTCL) is an uncommon type of cancer that begins in white blood cells called T lymphocytes (T cells). Normally, T cells help body's immune system to fight off infection but, in CTCL, these cells develop abnormalities that make them attack the skin. It comprises heterogeneous group of skin neoplasms, the most common being mycosis fungoides (MF).  Skin lesions are classified into patches, plaques, and tumor stage. Extra skin manifestations like enlarged lymph nodes are usually seen in plaques or tumor stage, when there are thick lesions on skin. It is usually a slow growing cancer that develops over many years. Herein, we present an 83-year female patient who suddenly developed extremely itchy patches on abdomen, which had spread to involve the entire trunk and all four limbs in about 10 days’ time. She already had lymphadenopathy and splenomegaly at the time of presentation. Skin biopsy and immunohistochemistry revealed CD4+ T cells CTCL.  Moreover, bone marrow was hypercellular for age with 12% atypical lymphocytes. It is very unusual for CTCL to involve bone marrow at patch stage with no any plaques or nodules on the skin. Also, the sudden onset of skin lesions and its rapid progression with probably, the involvement of lymph nodes and spleen warrant further studies to guide diagnostic approaches and treatment recommendations for CTCL
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institution Kabale University
issn 2091-0231
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language English
publishDate 2023-03-01
publisher Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)
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spelling doaj-art-218e14439824472499a11c3fbd124d2c2025-08-23T10:03:45ZengSociety of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)Nepal Journal of Dermatology, Venereology & Leprology2091-02312091-167X2023-03-0121110.3126/njdvl.v21i1.52161Rapid Progression of Red Itchy Rash, Diagnostic DilemmaUma Keyal0Gopi Aryal1Sanju Babu Shrestha2Anil Kumar Bhatta3Department of Dermatology, Nepal Mediciti Hospital, Lalitpur, Kathmandu, NepalDepartment of Pathology, Nepal Mediciti Hospital, Lalitpur, Kathmandu, NepalDepartment of Dermatology, Nepal Mediciti Hospital, Lalitpur, Kathmandu, NepalDerm Dynamics Skin Hair and Laser Clinic, Kumaripati, Lalitpur, Kathmandu, Nepal Cutaneous T-cell lymphoma (CTCL) is an uncommon type of cancer that begins in white blood cells called T lymphocytes (T cells). Normally, T cells help body's immune system to fight off infection but, in CTCL, these cells develop abnormalities that make them attack the skin. It comprises heterogeneous group of skin neoplasms, the most common being mycosis fungoides (MF).  Skin lesions are classified into patches, plaques, and tumor stage. Extra skin manifestations like enlarged lymph nodes are usually seen in plaques or tumor stage, when there are thick lesions on skin. It is usually a slow growing cancer that develops over many years. Herein, we present an 83-year female patient who suddenly developed extremely itchy patches on abdomen, which had spread to involve the entire trunk and all four limbs in about 10 days’ time. She already had lymphadenopathy and splenomegaly at the time of presentation. Skin biopsy and immunohistochemistry revealed CD4+ T cells CTCL.  Moreover, bone marrow was hypercellular for age with 12% atypical lymphocytes. It is very unusual for CTCL to involve bone marrow at patch stage with no any plaques or nodules on the skin. Also, the sudden onset of skin lesions and its rapid progression with probably, the involvement of lymph nodes and spleen warrant further studies to guide diagnostic approaches and treatment recommendations for CTCL https://www.nepjol.info/index.php/NJDVL/article/view/52161Cutaneous T cell lymphoma, mycosis fungoides, skin neoplasm, T lymphocytes.
spellingShingle Uma Keyal
Gopi Aryal
Sanju Babu Shrestha
Anil Kumar Bhatta
Rapid Progression of Red Itchy Rash, Diagnostic Dilemma
Nepal Journal of Dermatology, Venereology & Leprology
Cutaneous T cell lymphoma, mycosis fungoides, skin neoplasm, T lymphocytes.
title Rapid Progression of Red Itchy Rash, Diagnostic Dilemma
title_full Rapid Progression of Red Itchy Rash, Diagnostic Dilemma
title_fullStr Rapid Progression of Red Itchy Rash, Diagnostic Dilemma
title_full_unstemmed Rapid Progression of Red Itchy Rash, Diagnostic Dilemma
title_short Rapid Progression of Red Itchy Rash, Diagnostic Dilemma
title_sort rapid progression of red itchy rash diagnostic dilemma
topic Cutaneous T cell lymphoma, mycosis fungoides, skin neoplasm, T lymphocytes.
url https://www.nepjol.info/index.php/NJDVL/article/view/52161
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AT sanjubabushrestha rapidprogressionofreditchyrashdiagnosticdilemma
AT anilkumarbhatta rapidprogressionofreditchyrashdiagnosticdilemma