Specific cutaneous infiltrates of an extracutaneous B-cell lymphoma following a herpes simplex infection

Both herpes simplex and herpes tester are not uncommon in patients affected by malignant lymphoma or leukemia. Of particular interest, the herpetic le sions may be followed by specific cutaneous infiltrates. We report on a pat ient with a centrocytic-centroblastic non-Hodgkin lymphoma who showed prima ry skin infiltrates within the area affected by herpes simplex. After effec tive therapy with aciclovir, papules and plaques developed at the site of t he herpetic scars. Histologic investigation confirmed dense B-lymphocytic i nfiltrates with immunoglobulin light chain restriction and a granulomatous reaction. Although the chemotherapeutical regiment was modified, the patien t died one month later of a lethal blast crisis. The occurrence of so calle d isotopic skin reactions and their prognostic significance is discussed.