ERYTHRODERMA AND MARKED ATYPICAL LYMPHOCYTOSIS MIMICKING CUTANEOUS T-CELL LYMPHOMA PROBABLY CAUSED BY PHENOBARBITAL

A 56-year-old man had been treated with phenobarbital seven weeks prio r to admission. One month after initiation of administration of phenob arbital, fever, skin rash and lymphadenopathy occurred. Nine days late r, marked atypical lymphocytosis, eosinophilia and hepatic injury was noticed. The histology of the biopsied skin was indistinguishable from lymphoma. CHOP-therapy was started but the patient was followed witho ut further treatment because of polyclonal T-lymphocytosis. Afterward, clinical and hematologic improvement ensued and he has been well unti l now, 52 months later. The marked T-lymphocytosis observed in this ca se is probably a lymphoid leukemoid reaction secondary to hypersensiti vity to phenobarbital.