A sinister itch: prurigo nodularis in Hodgkin lymphoma.

A 24 year old lady presented with pruritis and lichenified nodular skin lesions for 1 year. She also had clinical features to suggest a superior venacaval syndrome (SVC) with large rubbery cervical lymph nodes. She was subsequently diagnosed to have Hodgkin lymphoma on lymph node biopsy. Skin changes in lymphoma can precede other clinical symptoms by months. High clinical suspicion and thorough systemic examination would help in excluding a sinister problem in patients with chronic dermatosis.