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Brentuximab‐induced splinter nail haemorrhages in a patient with Sézary syndrome: A case report

Sézary syndrome is a systemic variant of cutaneous T‐cell lymphoma characterized by erythroderma, lymphadenopathy and circulating atypical lymphocytes (Sézary cells). It may present with nonspecific lesions on multiple digits. We describe an atypical case of brentuximab‐induced splinter nail haemorrhages in a patient with Sézary syndrome, associated with a poor prognosis during follow‐up. Concomitantly with the appearance of nail lesions, significant lymphocytosis was detected as well as infiltration of bone marrow and nail matrices. The lesions followed a precise sequence, which can be traced back to the monthly application of brentuximab and its direct cytotoxic effect on CD30+ T lymphocytes in the nail matrix. Brentuximab‐induced nail lesions might be associated with decreased efficacy of brentuximab in this patient with advanced cutaneous T‐cell lymphoma.