Acral Lentigines, Is it a Paraneoplastic Syndrome?

We report a 34 years old gentleman who was referred to us with multiple brown spots on the palms, soles and scalp. He had those three months prior to being diagnosed with non-Hodgkin s lymphoma. His past history includes both Evan s syndrome and membranoproilferative glomerulonephritis treated by mycophenolate mofetil (MMF). On examination he had multiple brownish macules over the palms, soles and scalp. Biopsy from one of the lesions on the palms showed pigmentation of the basal cell layer with increased melanocytes. His lentigines are most likely induced by immunosuppression due to Non-Hodgkin s lymphoma.