title: Small lymphocytic lymphoma with florid perniosis-like features: a case report.
abstract: BACKGROUND
  Small lymphocytic lymphoma is a relatively rare B-cell non-Hodgkin lymphoma that is considered to be the tissue equivalent of the much more common entity chronic lymphocytic leukemia. Cutaneous manifestations of small lymphocytic lymphoma are infrequent and the literature regarding them sparse. We describe here a case of a patient with a history of small lymphocytic lymphoma who developed perniosis-like features of the digits.
  
  
  METHODS
  An 86-year old male patient with previously diagnosed small lymphocytic lymphoma developed painful erythematous swelling of the periungual area of his fingers and toes. This was associated with a dense dermal infiltration of CD5-positive B-lymphoid cells consistent with his low-grade B-cell lymphoma. Although partially refractory to local radiotherapy, the painful swelling of the fingers and toes resolved fully following systemic therapy with chlorambucil and rituximab.
  
  
  CONCLUSIONS
  This unusual cutaneous manifestation of a lymphoma and the favourable response to systemic therapy may be instructive for the management of other patients who develop similar perniosis-like features.
authors.affiliation: Louisiana State University School of Medicine, 1501 Kings Hwy, Shreveport, LA, 71103, USA. tmorr4@lsuhsc.edu.
authors.forename: Taylor M
authors.initials: TM
authors.lastname: Morris
authors.affiliation: British Columbia Cancer Agency, 2410 Lee Avenue, Victoria, British Columbia, V8R 6 V5, Canada. rosetta.mazzola@bccancer.bc.ca.
authors.forename: Rosetta
authors.initials: R
authors.lastname: Mazzola
authors.affiliation: Department of Pathology, Island Health, Victoria, British Columbia, V8R 1 J8, Canada. brian.berry@viha.ca.
authors.forename: Brian
authors.initials: B
authors.lastname: Berry
authors.affiliation: Department of Pathology, Island Health, Victoria, British Columbia, V8R 1 J8, Canada. doug.sawyer@viha.ca.
authors.forename: Douglas
authors.initials: D
authors.lastname: Sawyer
authors.affiliation: British Columbia Cancer Agency, 2410 Lee Avenue, Victoria, British Columbia, V8R 6 V5, Canada. David.saltman@bccancer.bc.ca.
authors.forename: David L
authors.initials: DL
authors.lastname: Saltman
mesh_terms: D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002699:Chlorambucil / Q000627:therapeutic use; D004890:Erythema / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D005385:Fingers / Q000473:pathology*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D000069283:Rituximab / Q000627:therapeutic use; D014034:Toes / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents; D002699:Chlorambucil; D000069283:Rituximab