Interstitial Granulomatous Dermatitis as a Rare Paraneoplastic Manifestation of Non-small Cell Lung Cancer: A Case Report
Year: 2025
Type: article
Study design: Case Report
Abstract: Interstitial granulomatous dermatitis (IGD) is an uncommon inflammatory skin disorder, characterised histologically by mid‑dermal non‑caseating granulomas. While often linked to autoimmune diseases and drug reactions, its occurrence as a paraneoplastic phenomenon is rare. We report a case of a 69‑year‑old male with a two‑year history of a progressive erythematous maculopapular rash involving the trunk and extremities, associated with fatigue, weight loss, and myalgia. Initial superficial biopsy suggested granuloma annulare, but a deeper biopsy confirmed IGD, with a preserved Grentz zone and multinucleate giant cells. Laboratory tests revealed elevated ESR, as well as CRP, hypercalcaemia, and IgM paraproteinaemia. Imaging identified a PET‑avid, cavitating left lower lobe lung nodule. CT‑guided biopsy was non‑diagnostic, prompting wedge resection. Histology confirmed non‑small cell lung cancer, squamous subtype. Notably, the rash markedly improved following lung resection. IGD can be a cutaneous marker of occult malignancy. Persistent granulomatous skin eruptions unresponsive to standard therapies should prompt consideration of systemic disease, including neoplasia. This case underscores the value of a multidisciplinary diagnostic approach and highlights the potential for symptom resolution with targeted treatment of the underlying tumour.
Source: Cureus
DOI: 10.7759/cureus.90056
Authors: Maryam Abdurrahman, Zia Kanji
Institution: Milton Keynes Hospital
Language: English
Topic: Skin Diseases and Diabetes
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414166889
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