A 36-year-old Italian man with a 10-year-history of lymph nodal Hodgkindisease (stage IIb, nodular sclerosis type) presented with a solitary noduleof 6 months' duration on the right upper extremity. The patient had been treatedwith systemic chemotherapy (doxorubicin, bleomycin, vinblastine, and dacarbazine,every 15 days for 5 cycles), followed by radiation therapy, with completeremission of the disease for 9 years.
Physical examination revealed an erythematous, painless, nonpruritic,firm 1-cm nodule with sharply defined borders and tiny telangiectasias onthe surface; the nodule was located on the extensor surface of the right forearm(Figure 1). There was no historyof previous trauma to the area or systemic symptoms. Lymphadenopathy and hepatosplenomegalywere not detected. The complete blood cell count, erythrocyte sedimentationrate, blood chemistry analysis, urinalysis, electrocardiogram, and chest x-rayfilm revealed no abnormalities. An excisional biopsy of the skin lesion wasperformed, and the microscopic findings are shown in Figure 2 and Figure 3.
Fargnoli MC, Peris K, Cerroni L, Piccolo D, Chimenti S. A Nodule on the Forearm of a Patient With Hodgkin Disease. Arch Dermatol. 2001;137(1):85-90. doi: