Refractory interstitial granulomatous dermatitis in the setting of underlying diffuse large B-cell lymphoma




Interstitial granulomatous disease, Diffuse large B-cell lymphoma, Geriatric, Palisading infiltration of histiocytes, Necrotizing granulomatous inflammation


Interstitial granulomatous dermatitis is a rare dermatologic condition characterized by erythematous papules, nodules, and plaques, most commonly on the trunk and limbs. It is commonly associated with comorbidities such as arthritis, autoimmune disease, lymphoproliferative disorders, and malignancies. In addition, the rash can be medication-induced, which is differentiated by histopathologic results. Diagnosis is confirmed with skin biopsy, and treatment is individualized to each patient. Here we report an 89-year-old man with sudden onset lower extremity interstitial granulomatous dermatitis with the concurrent diagnosis of diffuse large B-cell lymphoma. Treatment of the skin lesions was attempted with a combination of steroids, antibiotics, antifungals, and disease-modifying anti-rheumatic drugs, without complete resolution.

Author Biographies

Trevor A. Nessel, Michigan State University College of Osteopathic Medicine, East Lansing, Michigan

Bachelor's of Science Degree

Medical Student

Jeffrey B. Morris, Department of Dermatology, Beaumont Trenton Hospital, Trenton, MI


German Treyger, Department of Dermatology, Beaumont Trenton Hospital, Trenton, MI


Connor C. Kerndt, Spectrum Health/Michigan State University College of Human Medicine, Grand Rapids, MI

Bachelor's of Science Degree

Medical Student

Bryan Sofen, Department of Dermatology, Beaumont Trenton Hospital, Trenton, MI



Interstitial Granulomatous Dermatitis - an overview Science Direct Topics. Available at Accessed on 14 March 2020.

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