Subcutaneous panniculitis-like T cell lymphoma: a rare entity and its cryptic journey through pregnancy

<p class="abstract">Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare form of skin lymphoma that primarily is localized to the subcutaneous adipose tissue and accounts for less than 1% of all peripheral T-cell lymphomas. It presents with multiple subcutaneous nodules or plaques on extremities and has poor prognosis if accompanied by hemophagocytic syndrome. Differential diagnosis is panniculitis, lupus panniculitis and leprosy. We report such a rare case of a female with lupus erythematosus (LE) panniculitis like presentation with favourable outcome to oral steroids in pregnancy.</p>

Subcutaneous panniculitis-like T cell lymphoma arising in association with chronic lymphocytic leukaemia

Subcutaneous panniculitis-like T cell lymphoma (SPTCL) is a rare cutaneous T cell malignancy of cytotoxic T cell origin. It is frequently associated with autoimmune diseases. It is known to preferentially involve subcutaneous adipose tissue and histologically resembles lupus panniculitis. The aetiology and risk factors of SPTCL are unclear and there are limited studies available since this entity was initially described in 2001. There are even fewer case reports describing the association between SPTCL and chronic lymphocytic leukemia (CLL). In this article, we present a case of SPTCL arising during treatment for CLL. We conducted an extensive review of literature to delve into the possible risk factors for SPTCL development in association with CLL, including pre-existing haematological malignancies, autoimmune conditions, immunomodulation and immunosuppressive chemotherapy.

Linear lupus panniculitis of scalp: a case report from north-east India

<p class="abstract">Lupus panniculitis of scalp is an uncommon manifestation of lupus erythematosus, which presents as non-scarring linear, arched, or annular alopecia along the lines of Blaschko. A 7 year old child presented with localised linear non-scarring alopecia on scalp. Examination revealed a single linear alopecic patch on the left parietal scalp. There were no associated systemic complaints. Skin biopsy showed atrophic lining epithelium, diffuse and nodular lymphocytic and plasma cells infiltrates in the superficial and deep dermis, lobular inflammatory infiltration of lymphocytes, histiocytes and plasma cells, with minimal involvement of septa in the subcutaneous tissue. Antinuclear Antibody (ANA) and anti-ds DNA tests were negative. Patient responded well with regrowth of terminal hair within 3 weeks to a combination treatment of hydroxychloroquine, topical and intralesional steroids, and topical calcineurin inhibitor. Linear lupus panniculitis of scalp should be considered in cases of patterned, non-scarring alopecia. Regular follow-up is also essential due to the possibility of recurrence and development of systemic lupus erythematosus.</p>

Lupus mastitis

Lupus mastitis Systemic lupus erythematosus (SLE) infrequently presents itself as lupus panniculitis. In lupus panniculitis the subcutaneous fat tissue is involved in the inflammatory process. Lupus mastitis is again a rare variant of lupus panniculitis, probably caused by an immune-mediated inflammatory process. In literature on the topic we can find 30 cases of lupus mastitis in men and women. Lupus mastitis may present like a breast lesion suspected to be malignant, clinically and radiologically. In the differential diagnosis we consider inflammatory breast cancer, subcutaneous panniculitis-like T-cell lymphoma (SPTL) and diabetes mastopathy. With a medical history of SLE and signs of inflammation of the skin above the lesion however, a diagnosis of lupus mastopathy is more presumable. Medical treatment seems more indicated in lupus mastitis, because delayed healing after surgical procedures is often reported. Even though methylprednisolone and chloroquine give clinical improvement, they need to be repeated often because of a high risk of relapse.