Sanchez EG, Ramos C, Ratnarajah K, Bravo FP, Del Solar MA, Le M, Netchiporouk E. Adenopathy and extensive skin patch overlying plasmacytoma syndrome—the clue to early diagnosis of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes: A case series and literature review.
SAGE Open Med Case Rep 2022;
10:2050313X221091602. [PMID:
35495293 PMCID:
PMC9052825 DOI:
10.1177/2050313x221091602]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Importance:
Adenopathy and extensive skin patch overlying plasmacytoma syndrome is a
paraneoplastic syndrome characterized by a cutaneous vascular patch
overlying a plasmacytoma and systemic manifestations. It is thought to be an
early stage of polyneuropathy, organomegaly, endocrinopathy, monoclonal
gammopathy, and skin changes syndrome, which is a rare, but potentially
fatal multisystemic disease that is associated with plasma cell dyscrasia.
Thus, a high index of suspicion is required to identify patients with
adenopathy and extensive skin patch overlying plasmacytoma as they may
present with early polyneuropathy, organomegaly, endocrinopathy, monoclonal
gammopathy, and skin changes, which is curable if detected early.
Objective:
To report additional cases of adenopathy and extensive skin patch overlying
plasmacytoma syndrome, describe dermatoscopic and histologic findings of the
cutaneous patch and review all up to date literature on adenopathy and
extensive skin patch overlying plasmacytoma syndrome.
Design:
Case series from a single tertiary care center.
Participants:
Here, we present the second case series of three patients with adenopathy and
extensive skin patch overlying plasmacytoma syndrome who all meet the
diagnostic criteria for polyneuropathy, organomegaly, endocrinopathy,
monoclonal gammopathy, and skin changes. The diagnosis was suspected based
on the presence of the violaceous cutaneous patch along with symptoms of
systemic involvement (fatigue, weight loss, weakness). Dermoscopy revealing
regular dilated parallel capillaries was suggestive of a benign/reactive
vascular process. Histopathology in all three cases showed reactive vascular
proliferation with a characteristic 90° branching. To date only 20 cases of
adenopathy and extensive skin patch overlying plasmacytoma have been
published, including ours. All patients presented with cutaneous lesions
(violaceous patch and others) and most, at least 15/20, met the diagnostic
criteria for polyneuropathy, organomegaly, endocrinopathy, monoclonal
gammopathy, and skin changes. When clinical follow-up was reported, most
patients had a favorable prognosis with partial or complete symptom
resolution following treatment of the underlying plasmocytoma.
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