Subacute Cutaneous Lupus as a Paraneoplastic Manifestation of Non-Hodgkin Lymphoma

Abstract

Malignancies have been associated with paraneoplastic syndromes, such as dermatomyositis. Subacute cutaneous lupus erythematosus (SCLE) can occur due to a wide array of cancers. Paraneoplastic SCLE obeys McLean's criteria and often regresses after the underlying malignancy has been treated appropriately. Anti-Ro/SSA antibodies are often present in patients with paraneoplastic SCLE; however, there have been many instances where anti-Ro may not be present. We report a case of non-Hodgkin lymphoma causing SCLE, a malignancy not previously known to be associated with paraneoplastic SCLE. We also highlight the importance of perhaps prompt chemotherapy to treat the underlying malignancy, as a failure to do so may lead to worse patient outcomes.

Keywords: follicular B-cell lymphoma; non-Hodgkin’s lymphoma; paraneoplastic syndrome; subacute cutaneous lupus erythematosus.

Figure 1.

(A) Initial rash on the left arm, (B) subsequent rash on the upper back, and (C) similar rash appearing on the left leg and (D) right arm.

Figure 2.

Vacuolar change of the basal keratinocytes is accompanied by tagging of lymphocytes along the dermal-epidermal junction. Brightly eosinophilic necrotic keratinocytes are found within all layers of the epidermis, and pale pink cytoid bodies are noted in the superficial most dermis. A mild perivascular infiltrate of lymphocytes is also present. (H&E stain, 20× magnification)