Index > Vol. 85/2005 > Iss. 4/July > pp. 333-336 > Abstract
Letter to the Editor

Generalized Eczema Craquele as a Presenting Feature of Systemic Lymphoma: Report of Seven Cases

doi: 10.1080/00015550510032841

Abstract:

Eczema craquele, or asteatotic eczema, has been associated with malignant lymphoma although this is rare. Since 1986, we have observed seven patients, six men and one woman, mean age 71.5 years (range 43–86 years), with systemic lymphoma and concurrent eczema craquele. Five patients had T-cell lymphoma, one had a B-cell lymphoma and one had Hodgkin's disease. All patients shared several characteristics: (1) a synchronous onset of eczema craquele and lymphoma, (2) generalized eczema, (3) absence of alternative disease or conditions that could favour the onset of eczema craquele, and (4) eczema refractory to topical corticosteroids and emollients, but which resolved upon lymphoma remission and invariably recurred with the lymphoma relapse. All the patients except one died within 1 year, most with active lymphoma. The finding of recalcitrant generalized eczema craquele should prompt a search for lymphoma, particularly in older men. Lymphoma-associated eczema craquele has most characteristics of paraneoplastic syndromes and may be a hallmark of aggressive lymphoma.

Key words:

eczema craquele, lymphoma

References:

  1. Caplan, R. M. (1970) Superficial haemorrhagic fissures of the skin. Arch Dermatol, 101, pp. 442 - 451.
  2. Warin, A. P. (1973) Eczema craquelé as the presenting feature of myxœdema. Br J Dermatol, 89, pp. 289 - 291.
  3. Horii, I. and Nakayama, Y. and Obata, M. and Tagami, H. (1989) Stratum corneum hydration and amino-acid content in xerotic skin. Br J Dermatol, 121, pp. 587 - 592.
  4. Akimoto, K. and Yoshikawa, N. and Higaki, Y. and Kawashima, M. and Imokawa, G. (1993) Quantitative analysis of stratum corneum lipids in xerosis asteatotic eczema. J Dermatol, 20, pp. 1 - 6.
  5. Murray, H. E. and Forsey, R. R. (1975) Eczema craquelé. Arch Dermatol, 111, pp. 1536.
  6. Braun-Falco, O.(1984) Eczema in the ederly.. In Dermatology, 3rd edn, Vol. 1. ( pp. 362 - 366 ). Berlin : Springer-Verlag.
  7. Blank, I. H. (1952) Factors which influence water content of stratum corneum. J Invest Dermatol, 18, pp. 433.
  8. Onken, H. D. and Moyer, C. A. (1963) The water barrier in human epidermis. Physical and chemical nature. Arch Dermatol, 87, pp. 584 - 590.
  9. Weismann, K. and Wadskov, S. and Mikkelson, H. (1978) Acquired zinc deficiency dermatosis in man. Arch Dermatol, 114, pp. 1509 - 1511.
  10. Weismann, K. (1978) Generalized eczéma craquelé: a marker of zinc deficiency? Br J Dermatol, 99, pp. 339 - 340.
  11. Prottey, C. and Hartop, P. J. and Press, M. (1975) Correction of the cutaneous manifestations of fatty acid deficiency in man by application of sunflower-seed oil. J Invest Dermatol, 64, pp. 228.
  12. Greist, M. C. and Epinette, W. W. (1982) Cimetidine induced xerosis and asteatotic dermatitis. Arch Dermatol, 118, pp. 253 - 254.
  13. Björnberg, J. (1982) Erythema craquelé provoked by corticosteroids on normal skin. Acta Derm Venereol, 62, pp. 147 - 151.
  14. Bhushan, M. and Cox, N. H. and Chalmers, R. J. G. (2001) Eczema craquelé resulting from acute oedema: a report of seven cases. Br J Dermatol, 145, pp. 355 - 357.
  15. Guillet, M. H. and Schollhammer, M. and Sassolas, B. and Guillet, G. (1996) Eczema craquelé as a pointer of internal malignancy – case report. Clin Exp Dermatol, 21, pp. 431 - 433.
  16. Barker, D. J. and Cotterill, J. A. (1977) Generalized eczéma craquelé as a presenting feature of lymphoma. Br J Dermatol, 97, pp. 323 - 326.
  17. Van Voorst Vader, P. C. and Folkers, E. and Van Rhenen, D. J. (1979) craquelé-like eruption in angioimmunoblastic lymphadenopathy. Arch Dermatol, 115, pp. 370.
  18. Burton, J. L. and Rook, A. and Wilkinson, D.(1986) Asteatotic eczema.. In Textbook of Dermatology, 4th edn, Vol 1. ( pp. 382 - 383 ). Oxford : Blackwell Scientific.
  19. Greenwood, R. (1983) Generalized eczéma craquelé as a presenting feature of adenocarcinoma. Br J Dermatol, 109, pp. 227 - 228.
  20. Ridley, C. M. (1984) Eczema craquelé and systemic carcinoma. Br J Dermatol, 110, pp. 246 - 251.
  21. Higgins, E. M. (1997) Eczema craquelé and internal malignancy. Clin Exp Dermatol, 22, pp. 206.
  22. Huilgol, S. C. and Hanna, M. J. (1996) Generalized eczema craquelé: a sign of internal malignancy. Australas J Dermatol, 37, pp. 161.
  23. Cooper, M. F. and Wilson, P. D. and Hartop, P. J. and Shuster, S. (1980) Acquired ichthyosis and impaired dermal lipogenesis in Hodgkin's disease. Br J Dermatol, 102, pp. 689 - 693.
  24. Saurat, J. H.(1999) Autres eczémas.. In Eczémas et dermatoses spongiformes, 3rd edn. ( pp. 31 - 79 ). Paris : Masson.
  25. Callen, J. P. and Bernardi, D. M. and Clark, R. A. and Weber, D. A. (2000) Adult-onset recalcitrant eczema: a marker of noncutaneous lymphoma or leukemia. J Am Acad Dermatol, 43, pp. 207 - 210.
  26. Barrière, H. (1984) Syndromes cutanés para-néoplasiques. Ann Med Interne, 135, pp. 662 - 668.
  27. Achten, G. and Ledoux-Corbusier, M. and Goens, J. (1984) Autonomie nosologique et pathogénie des syndromes paranéoplasiques cutanés. Ann Med Interne, 135, pp. 646 - 653.
  28. McLean, D. I. (1993) Toward a definition of cutaneous paraneoplastic syndrome. Clin Dermatol, 11, pp. 11 - 13.
  29. McLean, D. I. (1986) Cutaneous paraneoplastic syndromes. Arch Dermatol, 122, pp. 765 - 767.
  30. Curth, H. O.(1976) Skin lesions and internal carcinoma.. In Cancer of the skin: biology-diagnosis-management. ( pp. 1308 - 1341 ). Philadelphia : WB Saunders.
  31. Kurzrock, R. and Cohen, P. R. (1995) Mucocutaneous paraneoplastic manifestations of hematologic malignancies. Am J Med, 99, pp. 207 - 216.