A 50-year-old woman of Trinidadian descent presented with a 2-week history of asymptomatic, umbilicated, skin-colored facial papules. She had been diagnosed 2 years previously with human T-cell lymphotrophic virus type 1 (HTLV-1)–associated adult T-cell leukemia/lymphoma (ATLL). Since then, she had been treated with multiple chemotherapy regimens, but the only one eliciting a partial response was ICE (ifosfamide, carboplatin, and etoposide). However, she eventually experienced relapse, as confirmed by bone marrow biopsy.
Nguyen CV, Patel AR, Husain S, Grossman ME. Umbilicated Facial Papules in an Immunosuppressed Patient. JAMA Dermatol. 2013;149(9):1101-1102. doi:10.1001/jamadermatol.2013.353