Background: Small lymphocytic lymphoma is a relatively rare B-cell non-Hodgkin lymphoma that is considered\nto be the tissue equivalent of the much more common entity chronic lymphocytic leukemia. Cutaneous\nmanifestations of small lymphocytic lymphoma are infrequent and the literature regarding them sparse. We\ndescribe here a case of a patient with a history of small lymphocytic lymphoma who developed perniosis-like\nfeatures of the digits.\nCase presentation: An 86-year old male patient with previously diagnosed small lymphocytic lymphoma\ndeveloped painful erythematous swelling of the periungual area of his fingers and toes. This was associated with a\ndense dermal infiltration of CD5-positive B-lymphoid cells consistent with his low-grade B-cell lymphoma. Although\npartially refractory to local radiotherapy, the painful swelling of the fingers and toes resolved fully following\nsystemic therapy with chlorambucil and rituximab.\nConclusions: This unusual cutaneous manifestation of a lymphoma and the favourable response to systemic\ntherapy may be instructive for the management of other patients who develop similar perniosis-like features.
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