title: Cutaneous vasculitis as an initiating paraneoplastic symptom in Hodgkin lymphoma.
abstract: Skin vasculitis may be associated with infections and autoimmune diseases. Furthermore, vasculitis may appear as a paraneoplastic symptom. A 19-year-old male patient was examined with swollen joints and papules presented on lower extremitis. Laboratory results showed high erythrocyte sedimentation ratio, positive C reactive protein, increased number of leukocytes and high circulating immune complex level. Histopatology of skin biopsy specimen proved vasculitis. ANCA was not present. No other changes could be observed besides skin involvement. Symptoms disappeared on 0.5-mg/bwkg methylprednisolon therapy. Few weeks later, enlarged cervical lymph nodes developed besides fever and weight loss. Biopsy indicated the presence of mixed cell type Hodgkin lymphoma. Appropriate examinations revealed clinical stage III/B with favorable prognosis (IPS=2). After eight cycles of ABVD therapy complete remission was achieved as confirmed by FDG-PET. As a consequence of the treatment of Hodgkin lymphoma, vasculitis also disappeared. The present case report calls to attention the importance of careful examinations to exclude other diseases, especially malignancies that may remain at the background of cutaneous vasculitis. Treatment of the primary disease also results in the improvement of secondary skin vasculitis.
authors: 3rd Department of Institute for Internal Medicine, University of Debrecen Medical and Health Science Center, Móricz Zs. krt. 22., 4032 Debrecen, Hungary. zsocogo@gmail.com
authors: Zsófia
authors: Z
authors: Simon
authors: Tünde
authors: T
authors: Tarr
authors: László
authors: L
authors: Tóth
authors: Gabriella
authors: G
authors: Szucs
authors: Arpád
authors: A
authors: Illés
mesh_terms: D000328:Adult; D020031:Epstein-Barr Virus Infections / Q000150:complications; D006689:Hodgkin Disease / Q000150:complications*; D006801:Humans; D008297:Male; D010257:Paraneoplastic Syndromes / Q000209:etiology*; D017445:Skin Diseases, Vascular / Q000209:etiology*; D014657:Vasculitis / Q000209:etiology*