Primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma clinically simulating pyoderma gangrenosum

Abstract

Conflict of interest: none declared. Primary cutaneous aggressive epidermotropic CD8+ T‐cell lymphoma is a rare, recently recognized disease. We report a case presenting with a clinical resemblance to pyoderma gangrenosum (PG), and a particularly aggressive clinical course. A 19‐year‐old Chinese woman presented with a 1‐year history of painful papular lesions on the shoulders and back, which rapidly became necrotic, progressed to enlarging ulcers and spread to involve the face, limbs and breasts. She also had an intermittent fever. Some old lesions resolved but new lesions continued to develop, with extensive ulceration and pain. Despite treatment with prednisone, the lesions continued to increase in number and size. The patient had previously been healthy. On examination, disseminated well‐circumscribed ulcers, measuring 10–100 mm in diameter, some of which were deep with a purulent base and dusky‐red, raised, and undermined borders, were seen on the breasts and extensor surface of limbs, along with multiple violaceous papules (Fig. 1).