PMC5422724_01
a Prominent, large scales adhered to the extensor surface of the extremities. b Elastic, subcutaneous nodules were detected on the bilateral wrists. c Atypical lymphoid cells densely infiltrated from the upper dermis to the subcutaneous tissue, with involvement of the overlying epidermis. d Few atypical, large cells were detected in the lesional skin of the ichthyosis-like eruption. c, d Original magnification, x100.
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F1
On his initial visit, physical examination revealed prominent, large scales on the extensor surface of the extremities (Fig. 1a). Moreover, elastic, subcutaneous nodules were detected on the bilateral wrists (Fig. 1b). A biopsy specimen from the left wrist revealed atypical lymphoid cells densely infiltrated from the upper dermis to the subcutaneous tissue (Fig. 1c). In contrast, few atypical, large cells were detected in the lesional skin of an ichthyosis-like eruption (Fig. 1d).
a Ulcer with prominent necrotic tissue on the right shin. b Just before the administration of bexarotene. c Eight weeks after the administration of bexarotene.
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F2
During oral intake of prednisolone, he developed an ulcer with prominent necrotic tissue on the right shin (Fig. 2a), and we administered etoposide 50 mg/day for 1 year. The necrotic ulcer gradually improved with scarring, but a deep, vermicular ulcer remained (Fig. 2b). The ulcer was cured with scarring, and the ichthyosis-like scales diminished within 8 weeks after the administration of bexarotene (Fig. 2c).