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Primary cutaneous marginal zone lymphoma presenting with secondary chilblains of the toes
  1. Ali Zagham Nasir and
  2. Ryan Scott Burmeister
  1. Internal Medicine Residency, Trinity Health Saint Mary's - Grand Rapids, Grand Rapids, Michigan, USA
  1. Correspondence to Dr Ali Zagham Nasir; ali.nasir{at}


Cutaneous lymphoproliferative disorders include cutaneous manifestations of systemic B-cell or T-cell lymphoma and primary cutaneous lymphomas. Primary cutaneous B-cell lymphomas are subcategorised into four groups: primary cutaneous marginal zone lymphoma (PCMZL), primary cutaneous follicle centre lymphoma, primary cutaneous diffuse large B-cell lymphoma, leg-type and EBV-positive mucocutaneous tumour. Each of these cutaneous lymphoproliferative disorders has unique clinical and pathological features necessitating biopsy and staging to establish proper treatment. We present a case of PCMZL manifesting as secondary chilblains of the toes that was diagnosed with punch skin biopsy. The patient’s chilblains resolved with rituximab. This case underscores the importance of considering PCMZL and other cutaneous lymphoproliferative disorders in patients with dermatological manifestations and wounds refractory to first-line treatment.

  • Dermatology
  • Oncology
  • Skin cancer
  • Rheumatology

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  • Contributors RSB saw the patient. AZN collected and organised the data and drafted the paper. RSB reviewed and edited the paper. Both authors reviewed the final version prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.