PMC6120276_01
Necrotic lesions on the distal phalanges.
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Physical examination at admission highlighted necrotic lesions on the distal phalanges of both hands (except the thumbs) (Figure 1), enlarged lymph nodes in right axillary (3 cm), and right supraclavicular gaps (4 cm).
Resolution of necrotic lesions after 3 cycles of ABVD protocol (3 months from the HL diagnosis). Amputation of three phalanges was required.
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After surgery, a delay for healing due to acrosyndrome was not observed (Figure 2).
Lymph node biopsy sample. (a) Typical morphology of Reed-Sternberg cells, surrounded by a background of reactive inflammation, nodular sclerosis pattern (HE stain x40). Immunohistochemistry staining of the Reed-Sternberg population showed expression of (b) CD15 and (c) CD30. (d) CD20 expression was negative.
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Biopsy of axillary nodes demonstrated nodular sclerosis classical Hodgkin's lymphoma (HL) (Figure 3).