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Forum Name: Lymphoma

Question: Long term Skin Rashes, could it be Lymphoma?


 pleaseadvise - Sat Aug 25, 2007 10:31 pm

Dear All,

About me: 31 yr Male
No Past Diagonosis or Surgeries. Any recent diagnosis and medication is below.

Below is the list of symptoms. I would appreciate if you could please advise me with regard to my questions at the end (and any other suggestion is most welcome):
1. I have skin "rashes". Not sure how to describe them. But they are NOT itchy, they ARE DARK RED to BLACK, skin is DRY, ROUGH and SCALY.
2. It does NOT pain there (at least so far).
3. One of the rashes is on right thigh (almost in the middle of the thigh)..has been there for almost 10-15 years now. It started out due to bad weather, extreme dryness or cold. But it stayed on and has been like this for 10-15 years
4. The other one developed more recently about a year or two back near elbow on the RHS. It would come and go but it has stayed on now. (this rash got bigger and freaked me out to go to the doctor).
5. A third one is near the ACL on right leg a few inches below the first rash above. This one has also developed in the last couple of years.
6. All the above rashes are spread out over a few square inches.
7. My recent blood test shows relative lymphocytes count of 41.9% (reference range 15-49). I don't have any other past blood test report to compare with.
8. my dermatalogist gave me some version of corticosteroid (external application) for the above rashes and nothing has changed so far.(4 weeks)

9. In my last visit my doctor raised the possibility of lymphoma and suggested biopsy (taking some skin tissue) using local anesthesia.

my questions:
1. Could the above symptoms be lymphoma?
2. Is the relative lymphocytes count too high? and indicative of a problem?
3. I am not very keen on a biopsy: any other tests not involving any cut or bruise that could clear the situation?
4. If at all biopsy is the only way out--is it safe? can it trigger the cancer and make it spread? what are the side effects? Can i get back to work right away after biopsy, literally the next moment as we could after a simple blood test?
 Dr. Chan Lowe - Mon Sep 17, 2007 9:03 pm

User avatar Hi Pleaseadvise,

Regarding your questions:
1) It could be lymphoma although I think this is highly unlikely. There are some lymphoma-like conditions that can cause rashes although I think it is unlikely for it to go 10 years without progressive symptoms.

2) Your relative lymphocyte count is normal. I would not consider this an indication of any specific disease.

3&4) I think a biopsy would actually be quite helpful. Persistent skin rashes that are not able to be diagnosed often can be determined by a biopsy. A simple punch biopsy is generally all that is needed. This biopsy involves numbing the skin with a local anesthetic and using a "punch" to remove a small piece of skin (often about 3-5mm in size). The biopsy site often doesn't even need a bandaid it is so small. It should be painless. The biopsies do not increase the risk of developing cancer or causing what ever this is to spread.

The biopsy can be done in the office generally and should not impact your ability to work at all. Results take a day or two, generally. The skin needs to be analyzed under a microscope and may need some specialized staining done.

Best wishes.
 pleaseadvise - Tue Sep 18, 2007 8:09 pm

Dear Dr Lowe (and all other as well),

Thank you for your reply and time, Dr Lowe. I really appreciate it.

1. The fact that these rashes and darkening of skin are happening at different places and over different periods of time some developing over the last year or so not be considered as progressive?
2. Also my doctor mentioned something like Cutaneous(?) T cell lymphoma and said that it develops as a rash where as in fact it is a sign of lymphoma. Any thoughts?

3. for biopsy..i still have not been able to get myself around to do it.. and havent been able to speak to my family about it..

thanks again so much

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