Hodgkin's Lymphoma Presenting as Alopecia

In 2012, a case report was published describing a 30-year-old female patient who presented with symptoms of generalized itching, diffuse hair loss, and progressive skin darkening over a period of 6 months. These symptoms were followed by a dry cough, intermittent fever, weight loss, and appetite loss. She also noticed painless swellings in her neck, axilla, and groin. Upon examination, she exhibited diffuse hyperpigmentation and generalized hair loss, including on the scalp, eyebrows, axilla, and groin, as well as generalized lymphadenopathy and hepatomegaly. Laboratory tests were largely normal, but she had an elevated erythrocyte sedimentation rate (ESR) and hypoalbuminemia. Imaging revealed hepatomegaly, splenic involvement, and pleural effusion, among other findings. A lymph node biopsy showed features consistent with Hodgkin's lymphoma, and the patient was positive for CD30 on immunohistochemistry. She was diagnosed with Hodgkin's lymphoma and began treatment with the ABVD chemotherapy regimen, showing significant clinical improvement after the first cycle. The case highlighted the importance of considering an underlying malignancy in patients presenting with cutaneous manifestations such as alopecia, which in this case was a paraneoplastic manifestation of Hodgkin's lymphoma.