Itching attacks with generalized hyperhydrosis as initial symptoms of Hodgkin's disease

ABSTRACT Background Clinical signs of Hodgkin's disease are unexplained weight loss, nocturnal sweating, fever and more or less permanent itching or pain around the affected lymphnodes, especially after alcohol consumption. Paraneoplastic symptoms are major challenges to the dermatologist, particularly if these seem harmless, though somewhat strange, as in the following case. Observation A 35‐year‐old patient had suffered for about 6 months from paroxysmal severe itching. A transient, generalized hyperhydrosis followed these attacks closely. The itching attacks usually began between the fingers and on the palms of the hands, and then spread to become generalized over the entire integument. The itching attacks commonly occurred three times daily for only a few minutes, while the subsequent severe hyperhydrosis, with cold sweat, lasted up to an hour. Conclusions This case illustrates the necessity of considering a malignant underlying disease like Hodgkin's disease, not only in the presence of the well‐known B‐symptoms, but also when peculiar symptom combinations, like itching attacks and immediately subsequent transient generalized hyperhydrosis are present.