Fiorillo G1,2*, Cortese A1,2, Toso F1,2 and Costanzo A1,3
1Department of Dermatology, Humanitas Research Hospital - IRCCS, Italy
2Humanitas University, Italy
3Department of Biomedical Sciences, Humanitas University, Italy
Erythroderma is a generalized erythema and scaling involving >80% to 90% of the body surface area. It is due to generalization of pre-existing dermatoses, drug reactions, or cutaneous T-cell lymphoma, but identification of the underlying disease process represents one of the most complex challenges in dermatology. We present the case of a 66-year-old male with multiple myeloma who developed erythroderma. He reported no pre-existing dermatoses or allergies; he was recently started on valganciclovir, but there was no improvement despite its suspension. Furthermore, mites could not be identified from skin scraping examined microscopically, and a screening test panel for associated auto antibodies was negative. Histological examination of a 4-mm punch biopsy showed findings of paraneoplastic erythroderma, idiopathic erythroderma and atopic dermatitis. Tests for multiple myeloma showed no evidence of disease activity and a second biopsy excluded again a lymphoproliferative disease, thus we proposed a clinical diagnosis of atopic dermatitis. The onset of erythroderma was associated with a cytomegalovirus reactivation twice, and the second time antiviral therapy resulted in improvement of erythema and itching. We believe that cytomegalovirus might have unleashed an erythrodermic onset of atopic dermatitis.
Atopic dermatitis; Myeloma; Viral disease
Fiorillo G, Cortese A, Toso F, Costanzo A. Erythrodermic Onset of Atopic Dermatitis in a Patient with Multiple Myeloma: The Role of Cytomegalovirus Infection. Clin Case Rep Int. 2022; 6: 1385.