Extraordinary Case ReportLeukocytoclastic Vasculitis as Early Manifestation of Epstein-Barr Virus–Positive Diffuse Large B-Cell Lymphoma of the ElderlyZoroquiain, Pablo MD; González, Sergio MD; Molgó, Montserrat MD; Rodríguez, Alejandra MD; Valbuena, JoséR MD Author Information Departments of *Anatomic Pathology †Dermatology ‡Hematology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. The authors state that they do not have conflicts of interest in the manuscript. Reprints: José R. Valbuena, MD, Department of Anatomic Pathology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Lira 85, 4° Piso, Santiago, Chile (e-mail: [email protected]). The American Journal of Dermatopathology: May 2012 - Volume 34 - Issue 3 - p 330-334 doi: 10.1097/DAD.0b013e3182318dd9 Buy Metrics Abstract Extensive necrotizing vasculitis (ENV) is a rare paraneoplastic phenomenon, and the majority of cases reported are associated with hematolymphoid neoplasms. Histologically, most cases of ENV represent leukocytoclastic vasculitis (LCV). Here we report the clinicopahological features of a 68-year-old man with ENV associated to a Epstein Barr virus-positive diffuse large B-cell lymphoma (EBV+DLBCL) of the elderly, a newly recognized lymphoproliferative disorder, most likely representing a paraneoplastic manifestation. The patient was treated with standard chemotherapy regimen for malignant lymphoma. Due to the extensive involvement of the extremities by ENV, surgical debridement was not feasible and a novel therapy based on CHITOSAN apposits was initiated with overall good response and subsequent re-epithelization of the skin lesions. The patient died of sepsis secondary to a Pseudomona pneumonia 17 months after diagnosis. Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.