ABSTRACT
Primary cutaneous anaplastic large cell lymphoma (C-ALCL) is categorized as primary cutaneous CD30+ lymphoproliferative disorders, according to the recent WHO-EORTC classification of cutaneous lymphomas. This group includes primary C-ALCL, lymphomatoid papulosis (LyP). Most patients of C-ALCL present with solitary or localized nodules or papules, and often show ulceration. Multiple keratoacanthoma-like lesions are unusual. As far as we know, there are five reported cases. Currently, there is no universally accepted standard therapeutic approach for cases of multifocal C-ALCL. The combination chemotherapy is considered the most appropriate first-line treatment. We present a rare case of C-ALCL with multifocal keratoacathoma-like tumors with a challenging treatment regimen. A 56-year-old Thai woman developed multiple asymptomatic ulcerated nodules on her trunk, and extremities for 5 months. The provisional diagnosis was keratoacanthoma but histopathology and immunohistochemical studies revealed CD30+ ALCL. She received many regimens of chemotherapy, but responded well to the ESHAP (etoposide, methylprednisolone, cisplatin, cytosar) regimen.