Surgical treatment of obstructive palpebral tumors in d'emblee variant of cutaneous T-cell lymphoma.

BACKGROUND: Our patient presented with an unusual case of rapidly growing palpebral tumors, which obstructed his vision and caused professional and social impairment. OBJECTIVES: The objective was to report the role of surgical management in a case of the d'emblee variant of cutaneous T-cell lymphoma and to provide a literature review. METHODS: Tumors of the eyelids previously treated with topical and oral retinoids, indomethacin, dapsone, systemic chemotherapy, and high-dose systemic corticosteroids respond finally to conservative excision and second intention healing. RESULTS: Surgical debulking of palpebral tumors achieved remission of a locally aggressive form of cutaneous T-cell lymphoma and significant restoration of the sight, eyelid function, and social/professional function. CONCLUSION: In selected cases, surgical excision of tumor tissue may be of significant assistance in managing d'emblee variant cutaneous T-cell lymphoma.

Generalized eczematous contact dermatitis from cocobolo wood.

Occupational contact with cocobolo wood (Papilionaceae, Dalbergia retusa) has been reported to rarely cause delayed hypersensitivity reactions. We report the case of a 53-year-old furniture and cabinetmaker who exhibited a generalized reaction mimicking erythroderma after exposure to sawdust from the wood. Patch testing to plants and woods standard (Chemotechnique, Dormer Laboratories, Ontario, Canada) was negative, and the specific allergen in cocobolo, obtusaquinone, was not available to us. The patient was tested instead to shavings of various woods as well as to sawdust of the suspected wood in petrolatum. He exhibited an exuberant response (+++) to both shavings and sawdust of cocobolo. After successful patch testing with shavings and sawdust in the absence of the purified chemical allergen, avoidance of the timber resulted in the resolution of his symptoms.