Lichen Planus-Like Rash Masks Rare T-Cell Lymphoma
A case report describes a 61-year-old man whose persistent lesions were repeatedly misdiagnosed before lymphoma was identified.
Updated on Nov. 6, 2026 in Cancer
Researchers reported a 61-year-old man diagnosed with systemic peripheral T-cell lymphoma after lichen planus-like lesions were initially treated as oral lichen planus. The patient improved substantially with combination chemotherapy and supportive dermatologic care.
Why it matters
The case illustrates how a cancer can present as a common inflammatory skin and mouth condition, delaying accurate diagnosis for years. It highlights the value of re-evaluating patients who fail to respond to standard treatment.
The case report documents aberrant T lymphocytes accounting for 91.72% of lymphocytes on lymph node flow cytometry in a 61-year-old patient. Whether this presentation is typical of systemic peripheral T-cell lymphoma remains unknown from a single case.
The players
Skin
Skin is a peer-reviewed dermatology journal that published the case report describing this patient.
The details
The patient had a two-year history of painful mucosal lesions and pruritic violaceous plaques, and was repeatedly diagnosed with oral lichen planus. Lymph node biopsy showed atypical lymphoid hyperplasia with vascular invasion, leading to a final diagnosis of systemic peripheral T-cell lymphoma, not otherwise specified.
Timeline
Two years of symptoms preceded the diagnosis.
The case report was published in Skin in 2026.
Health Landscape
Dermatologists have long recognized that lichenoid eruptions can sometimes signal underlying lymphoma rather than a benign inflammatory condition. This report adds a systemic T-cell case to that body of clinical observation, underscoring the importance of biopsy when standard therapy fails.
Persistent or treatment-resistant oral and skin lesions that do not respond to standard therapy may warrant a biopsy rather than repeated diagnosis of a benign condition. Patients should raise concerns about lack of improvement with their clinicians.
The takeaway
Chronic lichenoid lesions that fail to respond to standard treatment should prompt consideration of lymphoma. Early biopsy can shorten the path to an accurate diagnosis.
Further reading
For related context, explore our Cancer coverage.
More information
Read the full Skin journal case report on refractory lichen planus-like disease.
Source note: This article includes information reported by News-Medical.
