Primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoma associated with an annular elastolytic giant cell granuloma

Abstract

Conflicts of interest: none declared. Sir, We describe herein the first association of a primary cutaneous CD4+ small to medium‐sized pleomorphic T‐cell lymphoma with an annular elastolytic giant cell granuloma, occurring simultaneously in a 62‐year‐old man. The appearance of the annular elastolytic giant cell granuloma some weeks before the cutaneous lymphoma and its regression during the treatment of the neoplasia made us think about the possible link between these two diseases. Primary cutaneous CD4+ small to medium‐sized pleomorphic T‐cell lymphoma (PSMTCL) is a provisional entity in the new WHO–EORTC classification,1 representing about 3% of all primary cutaneous T‐cell lymphomas (CTCL). We describe here an exceptional case of a 62‐year‐old man who simultaneously presented a PSMTCL and an annular elastolytic giant cell granuloma. For 6 months a 62‐year‐old white man had a slowly growing erythematous plaque on the lower left side of the abdomen. It was 6 × 14 cm in size and deeply infiltrated. Furthermore, for 8 months he had had an eruption of annular skin lesions mostly in photoexposed areas; these showed a centrifugal extension, and were atrophic and white in their centre with an infiltrated and erythematous border (Fig. 1). A few lesions were located on nonphotoexposed areas in the cutaneous folds as well. His general health was good and there was no lymphadenopathy or organomegaly. The past medical history was significant for glaucoma (treated with travoprost and picloxydine eye drops), and an iodine and penicillin allergy.