# Insidious Manifestations of Cutaneous T-cell Lymphoma

## TL;DR

A 66-year-old man with a persistent skin rash was eventually diagnosed with cutaneous T-cell lymphoma, highlighting the challenges of diagnosing rare skin conditions in the emergency department.

## Contribution

The paper presents a case emphasizing the importance of considering rare diagnoses in persistent rashes and the need for timely specialist involvement.

## Key findings

- The patient's rash was ultimately diagnosed as cutaneous T-cell lymphoma after initial misdiagnosis.
- Emergency physicians should consider rare conditions and expedite specialist evaluations when warranted.
- Inpatient management was necessary for accurate diagnosis and treatment.

## Abstract

A 66-year-old gentleman presented with several months of a generalized pruritic skin eruption along his face, thorax, and extremities. Although he had been seen previously, no diagnosis was made until he presented to the emergency department (ED) with worsening lesions. The patient was ultimately diagnosed with cutaneous T-cell lymphoma.

Accurately diagnosing a rash in the ED is not always possible as more invasive studies may be needed. Emergency physicians can expedite these studies where there is a high suspicion for a diagnosis that may need urgent evaluation and management by specialists through hospital admission and appropriate consultations. The clinical images here are an example of a rare disease manifesting as a debilitating rash, requiring inpatient evaluation and management.