A 26-year-old man with stage IV Hodgkin lymphoma developed a firm plaque on his left forearm 1 week before evaluation. Two months earlier, a hospital admission for chemotherapy had been complicated by renal failure, respiratory failure requiring prolonged ventilatory support, Staphylococcus aureus and Candida tropicalis septicemia, and repeated episodes of pneumonia. On the volar surface of his left forearm, an irregular 2×2-cm, pink, indurated plaque containing firm, crusted, yellow-white papules was noted; a linear subcutaneous plaque coursed proximally from the main lesion (Figure 1). A skin biopsy specimen with special staining is shown in Figure 2.
Gibney MD, Glaser DA. Firm Plaque of the Forearm in a Patient With Hodgkin Lymphoma. Arch Dermatol. 1998;134(1):97-102. doi: