Rare Presentation of Disseminated Follicular Lymphoma as an Ill-Defined Reticular Patch Over the Scalp and Forehead
April 2019
in “
JAAD case reports
”
TLDR A woman with lymphoma had a rare skin rash on her scalp and forehead, which was hard to diagnose but responded well to treatment.
The document reports a rare case of a 62-year-old woman with a history of stage IV grade 1 to 2 follicular B-cell lymphoma presenting with an ill-defined erythematous reticular patch over her scalp and forehead. This presentation is challenging to diagnose, especially if the presence of lymphoma is unknown, and may be mistaken for conditions like androgenic alopecia. Histopathology and immunohistochemistry confirmed the diagnosis of grade 1 to 2 follicular B-cell lymphoma, likely metastatic. Following the biopsy, the patient was treated with systemic rituximab, leading to near-complete resolution of the cutaneous lesion after 4 cycles, although a new similar lesion appeared later. The case emphasizes the importance of recognizing such cutaneous manifestations in patients with known lymphoma, as it may indicate disease progression and necessitate systemic treatment. The document also discusses the poorer prognosis of disseminated follicular lymphoma compared to primary cutaneous lymphoma and the use of rituximab to manage symptoms and disease burden.
