Erythrodermic Onset of Atopic Dermatitis in a Patient with Multiple Myeloma: The Role of Cytomegalovirus Infection

Fiorillo G, Cortese A1,2, Toso F and Costanzo A

Department of Dermatology, Humanitas Research Hospital - IRCCS, Italy
Humanitas University, Italy
Department of Biomedical Sciences, Humanitas University, Italy

^*Correspondance to: Giovanni Fiorillo 

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Abstract:

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.

Keywords:

Atopic dermatitis; Myeloma; Viral disease

Cite the Article:

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.