Case Report
Cutaneous Richter syndrome: a better place to transform?
Funding sources None.
Conflicts of interest None declared.
Some of the data contained within Tables and were extracted from a table published in Yamazaki et al. 2009 Primary cutaneous Richter syndrome: prognostic implications and review of the literature. J Am Acad Dermatol 2009; 60:157–61. The tables presented herein have been significantly expanded to include cases of cutaneous Richter syndrome reported subsequently and to examine further variables.
Summary
The development of high-grade lymphoma in patients with chronic lymphocytic leukaemia is known as Richter syndrome (RS) and is associated with a grave prognosis, with a mean survival of 8 months despite treatment. Cutaneous RS has been described in a handful of cases and may be associated with a better outcome than the more common extracutaneous variants. We review the literature with particular emphasis on pathogenesis, treatment and survival of RS. We postulate that the absence of B symptoms and a normal lactate dehydrogenase level, presumably reflecting localized or limited disease, and a lower tumour burden, may explain the apparently better survival in some patients with cutaneous RS than with extracutaneous variants.
