Clinical cases
Metatypical carcinoma nasal pyramid in a pacient with lewandowsky- lutz verruciformis epidermodisplasya and hodgkin lymphoma mixed cellularity
Immunosuppression is a fundamental parameter for the emergence and development of skin carcinomas.
Metatypical carcinoma represents approximately 5% of these tumors.
Lewandowsky-Lutz verruciformis epidermodisplasya is a rare condition that predisposes to skin infections with HPV, some of types are involved in the etiopathogenesis of skin carcinomas.
Hodgkin lymphoma (HL) is a malignant proliferation limfocito-histiocytic system, accompanied by granulo-matous inflammation characterized by presence of Reed-Sternberg cells.
We present a patient with EV and HL which developed a metatypical carcinoma on nasal pyramid.

Clinical case:
A 62-year old man, known with EV for 25 years and HL since 1989, presented for a circular ulcer, cover by hemorrhagic crust with 1.5cm diameter, located on  nasal pyramid appeared one year ago. Dermatological exam: circular ulcer, cover by hemorrhagic crust with 1.5cm diameter, located on  nasal pyramid, papules and tumors firms skin-colored, hiperkeratotic surface, dimensions between 0,4-1,6 cm located on the dorsa of the hands and feet. We performed surgical excision of tumor from nose and biopsy from a distal lesion and histological findings were metatypial carcinoma and verruca.

EV, through immunosuppresion well known and immunological disorders seen in HL plus treatment for this disease, we believe have contributed to the development of the metatypical carcinoma.
EV and HL pacients should be examined by dermatologist given the risk of developing skin cancers.