title: Secondary cutaneous marginal zone B-cell lymphoma presenting as lipoatrophy in a patient with hepatitis C.
abstract: BACKGROUND
  Hepatitis C viral infection is a significant public health problem; 170 million persons are infected worldwide and the prevalence in the southern part of the United States exceeds two percent. Extrahepatic manifestations of hepatitis C viral infection are common; notably, 15-20% of patients will develop cutaneous manifestations of their disease. There are numerous dermatologic diseases associated with hepatitis C infection, including lichen planus, leukocytoclasticvasculitis, and porphyria cutaneatarda.
  
  
  METHODS
  Recently, epidemiological studies have also demonstrated an association between hepatitis C infection and the development of non-Hodgkin lymphoma, especially marginal zone B-cell lymphoma. Herein we report the unusual case of a systemic marginal zone lymphoma in a patient with hepatitis C infection presenting clinically as localized lipoatrophy.
  
  
  CONCLUSIONS
  Lipoatrophy can be a rare and diagnostically challenging presentation of secondary cutaneous marginal zone B-cell lymphoma. The importance of early recognition and detection cannot be over emphasized, as new and effective anti-viral treatments can lead to lymphoma regression in up to 75% of patients. To our knowledge, this is the first case of hepatitis C viral infection associated marginal zone lymphoma to present as localized lipoatrophy.
authors.affiliation: Eastern Virginia Medical School, Department of Internal Medicine, 700 West Olney Road, Norfolk, VA, 23507, USA;
authors.forename: Kristyn
authors.initials: K
authors.lastname: Beck
authors.affiliation: Dartmouth Hitchcock Medical Center, Section of Dermatology, 18 Old Etna Road, Lebanon, NH, 03756, USA;
authors.forename: Joan
authors.initials: J
authors.lastname: Paul
authors.affiliation: Eastern Virginia Medical School, Department of Dermatology, 721 Fairfax Avenue, Suite 200, Norfolk, VA, 23507, USA;
authors.forename: Shilpa
authors.initials: S
authors.lastname: Sawardekar
authors.affiliation: Eastern Virginia Medical School, Department of Dermatology, 721 Fairfax Avenue, Suite 200, Norfolk, VA, 23507, USA; ; Hampton University Skin of Color Research Institute, Hampton University, Hampton, VA, USA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Harvey
keywords: atrophy; hepatitis C; lipoatrophy; lymphoma; panniculitis