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A Rare Presentation of Transformed, CD30+ High-Grade Cutaneous T-Cell Lymphoma of the Hallux

A Case Report

Brant L. McCartan Milwaukee Foot and Ankle Specialists, Milwaukee, WI.

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Bang Tang Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA.

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Allyson Berglund Department of Podiatry, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.

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John Giurini Department of Pathology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.

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German Pihan Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA.

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Cutaneous T-cell lymphoma is a type of non-Hodgkin's lymphoma, which is a neoplasm affecting the lymphatic system. Mycosis fungoides is the most common subset of cutaneous T-cell lymphoma and is often treated conservatively. This neoplasm is most common in adults older than 60 years and does not regularly manifest in the toes. A case is reported of a 70-year-old man seen for a nonhealing hallux ulceration leading to amputation. Histopathologic examination revealed a rare transformed CD30+ high-grade cutaneous T-cell lymphoma. The morbidity of lymphomas is highly dependent on type and grade. Pharmaceutical precision therapies exist that target specific molecular defects or abnormally expressed genes, such as high expression of CD30. This article focuses on treatment protocol and emphasizes the importance of early diagnosis, determination of cell type, and proper referral of atypical dermatologic lesions.

Corresponding author: Brant Lanser McCartan, DPM, MBA, MS, Milwaukee Foot and Ankle Specialists, 10125 W North Ave, Wauwatosa, WI 53226. (E-mail: dr.mccartan@yahoo.com)