An Adult-onset Recalcitrant Generalized Eczema Diagnosed as Hodgkin's Lymphoma

Generalized eczema with pruritus may be due to various causes including atopic dermatitis, contact allergy and drug ingestion. However, unexplained recalcitrant eczema may be associated with an underlying lymphoproliferative malignancy. A 41-year-old woman visited our clinic with a 3-month history of pruritic erythematous papules and nodules on the whole body. She was diagnosed as having prurigo nodularis and treated, but failed to respond to conventional treatment including steroids, cyclosporine and antihistamine. About 3 months later, the patient developed low-grade fever and night sweats. Computed tomography of the chest confirmed an enlarged lymph node suggestive of Hodgkin's lymphoma. Patients who have recalcitrant eczema should be evaluated with a careful examination for internal malignancies.