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Nuchanatanon T, Plangsiri S, Rattananukrom T. Primary cutaneous plasmacytosis successfully treated with topical corticosteroids and psoralen plus ultraviolet A: A case report. Clin Case Rep 2024; 12:e8624. [PMID: 38487639 PMCID: PMC10939998 DOI: 10.1002/ccr3.8624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 03/17/2024] Open
Abstract
We present a case of primary cutaneous plasmacytosis without systemic involvement. The patient received topical corticosteroids and psoralen plus ultraviolet A therapy, showing significant improvement. Continuous monitoring is underway despite the rarity of systemic manifestations.
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Affiliation(s)
- Thanyathorn Nuchanatanon
- Department of Community Medicine, Charoenkrung Pracharak Hospital, Medical Service DepartmentBangkok Metropolitan AdministrationBangkokThailand
| | - Settanan Plangsiri
- Faculty of Medicine, Ramathibodi HospitalMahidol UniversityBangkokThailand
| | - Teerapong Rattananukrom
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi HospitalMahidol UniversityBangkokThailand
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2
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Wei L, Zhang J, Di D, Wang D, Luo G. Cutaneous plasmacytosis Characterized by Head Plaques: An Unusual Case Report of a 57-Year-Old Male. Clin Cosmet Investig Dermatol 2023; 16:2021-2028. [PMID: 37560256 PMCID: PMC10408662 DOI: 10.2147/ccid.s418750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023]
Abstract
Cutaneous plasmacytosis (CP) is a rare disorder of uncertain etiology. We report an unusual and rare case of CP in a 57‑year‑old male who presented with popular nodules all over the body, accompanied by head plaques. Pathological biopsy of the skin revealed large infiltration of mature plasma cells within the dermis. Elevated serum IgG4 concentrations were found. Immunohistochemical analysis confirmed the polyclonal nature of the plasma cells. The diagnosis of CP was established. Steroid therapy was administered at a dose of 20 mg/day. After 1 month of treatment, the patient's eruption showed regression. These findings remind dermatologists to include CP in their clinical differential diagnosis of patients with head plaques. Meanwhile, clinicians should carefully that individuals diagnosed with CP at risk for malignant transformation.
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Affiliation(s)
- Lu Wei
- Department of Traditional Chinese Medicine Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Jialin Zhang
- Department of Traditional Chinese Medicine Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Dake Di
- Department of Traditional Chinese Medicine Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Dongmei Wang
- Department of Traditional Chinese Medicine Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Guangpu Luo
- Department of Traditional Chinese Medicine Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
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Antognoni MT, Misia AL, Brachelente C, Mechelli L, Paolini A, Miglio A. Non Epitheliotropic B-Cell Lymphoma with Plasmablastic Differentiation vs. Cutaneous Plasmacytosis in a 12-Years-Old Beagle: Case Presentation and Clinical Review. Vet Sci 2021; 8:vetsci8120317. [PMID: 34941844 PMCID: PMC8707514 DOI: 10.3390/vetsci8120317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022] Open
Abstract
Cutaneous lymphoid neoplasms and cutaneous plasmacytosis are rare in the dog; in human and in veterinary medicine, these have many clinical, cytological, histological, and phenotypic similarities, and a diagnosis of certainty is not easy. The aim of this study is to describe a case of cutaneous non epitheliotropic B-cell lymphoma (CNEBL) with plasmablastic differentiation vs. multiple cutaneous plasmacytosis (CP) in a dog, since the scarce bibliographic data on these topics. A 12-year-old male Beagle dog was presented for multiple, nodular, cutaneous, and subcutaneous, indolent masses disseminated on the whole body. Cytological, histological, flow cytometric, and immunohistochemical examinations, as well as complete radiographic evaluation, echocardiography, and abdominal ultrasound were performed. Cytology, histopathology, flow cytometric, and immunohistochemical examination, performed on the skin lesions, revealed a B-cell phenotype with plasmablastic differentiation. Nevertheless, a final diagnosis could not be achieved and it was categorized as a case of borderline CNEBL with plasmablastic differentiation versus CP. The dog was treated with a COP chemotherapeutic protocol. Total remission was obtained and relapse occurred 120 days later. To our knowledge, specific markers are actually unavailable to certainly differentiate CNEBL and CP in the dog and future studies are needed to improve knowledge on these pathologies in veterinary medicine, since prognosis and therapy are different.
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Affiliation(s)
- Maria Teresa Antognoni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06124 Perugia, Italy; (M.T.A.); (C.B.); (L.M.)
| | - Ambra Lisa Misia
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06124 Perugia, Italy; (M.T.A.); (C.B.); (L.M.)
- Correspondence: (A.L.M.); (A.M.)
| | - Chiara Brachelente
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06124 Perugia, Italy; (M.T.A.); (C.B.); (L.M.)
| | - Luca Mechelli
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06124 Perugia, Italy; (M.T.A.); (C.B.); (L.M.)
| | - Andrea Paolini
- Faculty of Veterinary Medicine, University of Teramo, Via Renato Balzarini 1, 64100 Teramo, Italy;
| | - Arianna Miglio
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06124 Perugia, Italy; (M.T.A.); (C.B.); (L.M.)
- Correspondence: (A.L.M.); (A.M.)
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Calugareanu A, Cordoliani F, Battistella M, Vignon-Pennamen MD, Lepelletier C, Bagot M, Bouaziz JD, Auffranc JC, Jachiet M, Petit A. [Cutaneous plasmacytosis with Darier's sign in a woman of European origin]. Ann Dermatol Venereol 2020; 147:552-557. [PMID: 32334844 DOI: 10.1016/j.annder.2020.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/13/2019] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Cutaneous plasmacytosis is a rare skin condition first described in 1976 and it is seen mainly in patients of Asian descent. Patients usually present with multiple reddish-brown macules and nodules chiefly on the trunk and face, with clusters of well-differentiated plasma cells in the dermis. The aetiopathogenesis and nosological features of this entity remain obscure. We report herein a case of cutaneous plasmacytosis in a European middle-aged woman with presence of Darier's sign. PATIENTS AND METHODS A 56-year-old woman of European descent presented with asymptomatic hyperpigmented patches affecting the dorsal aspect of her trunk for at least two years. Darier's sign was present in some episodes. Cutaneous biopsy showed a moderately dense interstitial and perivascular infiltrate containing numerous well-differentiated mature plasma cells affecting the entire dermal surface. Kappa and lambda immunochemistry demonstrated polyclonal plasma cell infiltrates with absence of light-chain restriction. Immunohistochemical examination was negative for HHV-8 and Treponema pallidum spirochetes. Laboratory findings revealed hypergammaglobulinaemia with no monoclonal bands being detected on immunofixation. A diagnosis of cutaneous plasmacytosis was made. In the absence of systemic involvement initial management consisted of clinical surveillance. DISCUSSION The characteristic clinico-pathological features of CP allowed diagnosis of this skin condition in our patient, although it is very rarely reported in patients of European descent. The main differential diagnoses were ruled out, namely plasmacytic infiltrates related to infections and marginal B-cell lymphoma.
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Affiliation(s)
- A Calugareanu
- Service de dermatologie, université Paris-Diderot-Paris VII, Sorbonne-Paris-Cité, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - F Cordoliani
- Service de dermatologie, université Paris-Diderot-Paris VII, Sorbonne-Paris-Cité, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Battistella
- Anatomopathologie, hôpital Saint-Louis, AP-HP, Paris, France
| | | | - C Lepelletier
- Service de dermatologie, université Paris-Diderot-Paris VII, Sorbonne-Paris-Cité, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Bagot
- Service de dermatologie, université Paris-Diderot-Paris VII, Sorbonne-Paris-Cité, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - J-D Bouaziz
- Service de dermatologie, université Paris-Diderot-Paris VII, Sorbonne-Paris-Cité, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | | | - M Jachiet
- Service de dermatologie, université Paris-Diderot-Paris VII, Sorbonne-Paris-Cité, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - A Petit
- Service de dermatologie, université Paris-Diderot-Paris VII, Sorbonne-Paris-Cité, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
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5
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Lee J, Lee JK, Kim J, Choi US, Seo KW. Multiple cutaneous plasmacytosis with multilobated (clover-leaf shaped) nuclei cells in a dog. Vet Med Sci 2020; 6:348-352. [PMID: 32056392 PMCID: PMC7397912 DOI: 10.1002/vms3.247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 12/09/2019] [Accepted: 01/14/2020] [Indexed: 11/11/2022] Open
Abstract
A 12‐year‐old female Shih‐tzu dog was presented with a 2‐month history of cutaneous non‐pruritic multiple ulcerated or crusted nodules of less than 1.5 cm in diameter on eyelids, lips, abdomen, groin, thighs and perianal region. Several diagnostic tests were performed, including fine needle aspiration and skin biopsy of the cutaneous nodules. Cytologic interpretation was round cell neoplasm with multilobated (clover‐leaf shaped) nuclei. Histopathology revealed round neoplastic cells with prominent anisocytosis and anisokaryosis, and numerous mitotic figures; however, the origin of the cells was not identified. Immunohistochemical evaluation indicated that these cells were positive for CD79a and MUM‐1, but negative for CD3, CD20 and Pax 5. The patient was treated with chemotherapy, and the skin condition improved. Despite good response to chemotherapy, the patient was euthanized due to poor general health.
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Affiliation(s)
- Jongbok Lee
- College of Veterinary Medicine, Kangwon National University, Chuncheon, Korea
| | - Jung Keun Lee
- College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
| | - Jawon Kim
- College of Veterinary Medicine, Chungnam National University, Daejeon, Korea
| | - Ul Soo Choi
- College of Veterinary Medicine, Chonbuk National University, Iksan si, Korea
| | - Kyoung Won Seo
- College of Veterinary Medicine, Chungnam National University, Daejeon, Korea
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7
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Cutaneous Plasmacytosis: A Clinicopathologic Study of a Series of Cases and Their Treatment Outcomes. Am J Dermatopathol 2018; 40:36-42. [DOI: 10.1097/dad.0000000000000907] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Isobe S, Ohashi N, Katahashi N, Ishigaki S, Tsuji N, Tsuji T, Kato A, Fujigaki Y, Shimizu A, Yasuda H. Focal segmental glomerulosclerosis associated with cutaneous and systemic plasmacytosis. CEN Case Rep 2017; 6:206-209. [PMID: 28939949 DOI: 10.1007/s13730-017-0276-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 09/14/2017] [Indexed: 12/28/2022] Open
Abstract
Cutaneous and systemic plasmacytosis (CSP) is a rare lymphoproliferative disorder that mainly affects middle-aged Asian individuals. Although Castleman disease is often complicated with various renal involvements, glomerulonephritis associated with CSP, which is considered as a variant of Castleman disease, is rare. This report presents the case of a 41-year-old Japanese man with nephrotic syndrome associated with CSP. Renal biopsy findings showed focal segmental glomerulosclerosis (FSGS) and diffusely mild segmental mesangial proliferation. Plasma cell infiltration in the interstitium was not observed. Electron microscopic findings showed diffuse foot process effacement, localized involvement of subendothelial space widening with amorphous materials, and endothelial cell swelling. Lymph node biopsy findings denied Castleman disease. His skin regions and proteinuria were successfully treated with prednisolone and cyclosporine. The causal relationship between CSP and FSGS is unknown. However, increased serum levels of IL-6 and VEGF and decreased VEGF expression in the podocyte may contribute to renal lesions in patients with CSP. To our best knowledge, this is the first case of a patient with FSGS associated with CSP.
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Affiliation(s)
- Shinsuke Isobe
- Internal Medicine 1, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan.
| | - Naro Ohashi
- Internal Medicine 1, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Naoko Katahashi
- Internal Medicine 1, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Sayaka Ishigaki
- Internal Medicine 1, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Naoko Tsuji
- Blood Purification Unit, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Takayuki Tsuji
- Internal Medicine 1, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Akihiko Kato
- Blood Purification Unit, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Yoshihide Fujigaki
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Akira Shimizu
- Department of Pathology, Nihon University School of Medicine, Tokyo, Japan
| | - Hideo Yasuda
- Internal Medicine 1, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
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Boostrom BO, Moore AS, DeRegis CJ, Robat C, Freeman K, Thamm DH. Canine Cutaneous Plasmacytosis: 21 Cases (2005-2015). J Vet Intern Med 2017; 31:1074-1080. [PMID: 28514049 PMCID: PMC5508321 DOI: 10.1111/jvim.14729] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/04/2017] [Accepted: 04/06/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Cutaneous plasmacytosis (CP) is a syndrome of multiple cutaneous plasma cell tumors, in the absence of multiple myeloma. Although rare in both humans and dogs, treatment recommendations are usually extrapolated from multiple myeloma protocols. To date, no case series of CP have been described in the veterinary literature. HYPOTHESIS/OBJECTIVES To describe clinical presentation, determine treatment response rates and duration, and report overall survival of dogs with CP. ANIMALS Twenty-one client-owned dogs with CP. METHODS Medical records of 21 dogs with CP were reviewed. Diagnosis was based on histopathologic evaluation of at least 1 representative cutaneous or subcutaneous lesion in dogs with ≥3 lesions. Dogs with suspicion of multiple myeloma were excluded. RESULTS The most commonly affected breeds were the golden (5/21) and Labrador retriever (3/21). Fourteen of 21 dogs had >10 lesions, with some having >100. Lesions commonly were described as round, raised, pink-to-red, and variably alopecic or ulcerated. The most commonly used drug protocol was combined melphalan and prednisone, with an overall response rate (ORR) of 73.7% (14/19 dogs). Single-agent lomustine was associated with a similar ORR of 71.4% (5/7 dogs). For all treatments combined, the median progression-free interval after the first treatment was 153 days. The median survival time from the first treatment was 542 days. CONCLUSIONS AND CLINICAL IMPORTANCE Alkylating agents were effective in inducing remission of CP; corticosteroids, melphalan, and lomustine were the most commonly used drugs. Survival times were similar to those reported in dogs with multiple myeloma treated with alkylating agents.
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Affiliation(s)
- B O Boostrom
- Colorado State University Flint Animal Cancer Center, Fort Collins, CO
| | - A S Moore
- Veterinary Oncology Consultants, Lake Innes, NSW, Australia
| | - C J DeRegis
- Pieper Memorial Veterinary Center, Middletown, CT
| | - C Robat
- University of Wisconsin Veterinary Medical Teaching Hospital, Madison, WI
| | - K Freeman
- Veterinary Cancer and Surgery Specialists, Milwaukie, OR
| | - D H Thamm
- Colorado State University Flint Animal Cancer Center, Fort Collins, CO
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10
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Goyal T, Varshney A, Zawar V, Sharma V. Primary Cutaneous Plasmacytosis: Masquerading as Hidradenitis Suppurativa. Indian J Dermatol 2016; 61:213-5. [PMID: 27057027 PMCID: PMC4817452 DOI: 10.4103/0019-5154.177768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Isolated cutaneous plasmacytosis (CP) is a rare entity with few cases reported in world literature. CP masquerading as hidradenitis suppurativa like presentation is a unique case with some features differentiating it clinically from it which were further confirmed by histopathology and immunostaining. Our case showed hyperplasia of mature plasma cells and polyclonal hypergammaglobulinemia, immunostaining for CD138 positivity and kappa: lambda ratio more than 3:1. Extensive clinical and laboratory investigations failed to reveal any underlying pathology, presence of any underlying disease accompanying the hypergammaglobulinemia and/or plasma cell proliferation.
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Affiliation(s)
- Tarang Goyal
- Department of Dermatology, Venereology and Leprosy, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, Uttar Pradesh, India
| | - Anupam Varshney
- Department of Pathology, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, Uttar Pradesh, India
| | - Vijay Zawar
- Consultant Dermatologist, Department of Dermatology, Skin Diseases Centre, Opp. Hotel Panchwati, Vakilwadi, M.G. Road, Nashik, Maharashtra, India
| | - Veena Sharma
- Department of Pathology, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, Uttar Pradesh, India
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11
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Lee TG, Jeong WS, Moon SH, Hwangbo H, Lee SK, Lee DR, Kwon TG. Cutaneous and Systemic Plasmacytosis Associated with Renal Amyloidosis. Ann Dermatol 2016; 27:759-62. [PMID: 26719649 PMCID: PMC4695432 DOI: 10.5021/ad.2015.27.6.759] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 07/24/2015] [Accepted: 08/10/2015] [Indexed: 11/09/2022] Open
Abstract
Cutaneous and systemic plasmacytosis (CSP) is a rare disorder of unknown etiology characterized by cutaneous polyclonal plasma cell infiltrates associated with various extracutaneous involvement and polyclonal hypergammaglobulinemia. Here, we report on a 54-year-old male patient with chronic renal insufficiency who presented with disseminated reddish-brown macules and plaques on the face and trunk. In our evaluation, he was found to have lymphadenopathy, polyclonal hypergammaglobulinemia; benign plasma cell infiltration involving the skin, bone marrow, and retroperitoneal area; and renal amyloidosis. To the best of our knowledge, this is the first reported case of CSP associated with renal amyloidosis.
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Affiliation(s)
- Taek Geun Lee
- Department of Dermatology, Maryknoll Medical Center, Busan, Korea
| | - Woo Seok Jeong
- Department of Dermatology, Maryknoll Medical Center, Busan, Korea
| | - Seung Hyun Moon
- Department of Dermatology, Maryknoll Medical Center, Busan, Korea
| | - Hyun Hwangbo
- Department of Dermatology, Maryknoll Medical Center, Busan, Korea
| | - Sook Kyung Lee
- Department of Dermatology, Maryknoll Medical Center, Busan, Korea
| | - Dong Ryeol Lee
- Department of Nephrology, Maryknoll Medical Center, Busan, Korea
| | - Tae Gwang Kwon
- Department of Dermatology, Severance Hospital & Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
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12
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Lu PH, Shih LY, Yang CH, Kuo TT. Cutaneous plasmacytosis: a clinicopathologic study of 12 cases in Taiwan revealing heterogeneous underlying causes. Int J Dermatol 2015; 54:1132-7. [DOI: 10.1111/ijd.12694] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 02/10/2014] [Accepted: 02/11/2014] [Indexed: 12/21/2022]
Affiliation(s)
- Pei-Hsuan Lu
- Department of Dermatology; Linkou Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Taoyuan Taiwan
| | - Lee-Yun Shih
- Department of Hematology and Oncology; Linkou Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Taoyuan Taiwan
| | - Chih-Hsun Yang
- Department of Dermatology; Linkou Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Taoyuan Taiwan
| | - Tseng-tong Kuo
- Department of Pathology; Linkou Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Taoyuan Taiwan
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13
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Hjira N, Baba N, Boudhas A, Bouzidi AA, Boui M. Cutaneous plasmacytosis: Report of a Moroccan case!! JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2014. [DOI: 10.1016/j.jssdds.2013.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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14
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Wagner G, Rose C, Klapper W, Sachse MM. Cutaneous and systemic plasmocytosis. J Dtsch Dermatol Ges 2013; 11:1161-7. [PMID: 23937389 DOI: 10.1111/ddg.12190] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 07/03/2013] [Indexed: 12/11/2022]
Abstract
Cutaneous and systemic plasmacytosis is a rare disorder observed mainly in Japanese that features an infiltration of mature plasma cells in various organ systems. In addition to the skin, lymph nodes and bone marrow are regularly affected. Laboratory tests show a polyclonal hypergammaglobulinemia. The cutaneous morphology is characterized by red to dark brown macules, papules and plaques a few centimeters in diameter, usually distributed symmetrically on the face, neck and back. Etiology and pathogenesis are not known. It is speculated that a reactive dysfunction of plasma cells may be triggered by various stimuli, such as interleukin 6. Treatment of cutaneous and systemic plasmacytosis is difficult. A standardized treatment concept does not yet exist. Topical corticosteroids and calcineurin inhibitors are mainly used.
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Affiliation(s)
- Gunnar Wagner
- Department of Dermatology, Allergology and Phlebology, Bremerhaven Reinkenheide Hospital, Bremerhaven, Germany
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15
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Honda R, Cerroni L, Tanikawa A, Ebihara T, Amagai M, Ishiko A. Cutaneous plasmacytosis: Report of 6 cases with or without systemic involvement. J Am Acad Dermatol 2013; 68:978-85. [DOI: 10.1016/j.jaad.2012.11.031] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 10/12/2012] [Accepted: 11/10/2012] [Indexed: 12/12/2022]
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16
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Cutaneous and Systemic Plasmacytosis Showing Histopathologic Features as Mixed-Type Castleman Disease. Am J Dermatopathol 2012; 34:553-6. [DOI: 10.1097/dad.0b013e3181f498e2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Haque M, Hou JS, Hisamichi K, Tamada K, Cusack CA, Abdelmalek M, Brown RE, Vonderheid EC. Cutaneous and systemic plasmacytosis vs. cutaneous plasmacytic castleman disease: review and speculations about pathogenesis. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2011; 11:453-61. [PMID: 21940235 DOI: 10.1016/j.clml.2011.07.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 07/15/2011] [Accepted: 07/15/2011] [Indexed: 12/23/2022]
Abstract
Cutaneous and systemic plasmacytosis (C/SP), human herpes virus-8 (HHV8), negative multicentric plasmacytic Castleman disease (MPCD), and idiopathic plasmacytic lymphadenopathy are polyclonal plasma cell proliferations of unknown etiology that predominantly affect Asian individuals. Herein, we present our experience with a Vietnamese man with typical C/SP limited to the skin but, after 10 years, may have developed perirenal involvement, and with a white man with human immunodeficiency virus and HHV8 negative MPCD with involvement of skin, lymph nodes, and kidneys at presentation, and who later succumbed to gastric carcinoma. Based on a review of the literature, we suggest that C/SP, cutaneous MPCD, and idiopathic plasmacytic lymphadenopathy with skin involvement are part of a continuum rather than distinct entities and, as such, may be regarded as variants of HHV8-negative MPCD. Although the majority of patients with C/SP run a chronic benign course, special attention should be given to monitoring for pulmonary and renal involvement. We hypothesize that long-lived plasma cells originate and survive in the environment of the skin akin to other stromal "survival" niches due to the local production of interleukin 6 and that such patients might respond to agents that interfere with interleukin-6 activity.
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Affiliation(s)
- Maryam Haque
- Department of Dermatology, Drexel University College of Medicine, Philadelphia, PA 19107, USA.
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18
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Extensive Hyperpigmented Plaques in a Chinese Singaporean Woman: A Case of Cutaneous Plasmacytosis. Am J Dermatopathol 2011; 33:498-503. [DOI: 10.1097/dad.0b013e3181ea1198] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Lee SH, Yoo CY, Jung JH, Yoo JY, Kang SJ, Kang CS. Systemic Plasmacytosis - A Case Report with a Review of the Literature -. KOREAN JOURNAL OF PATHOLOGY 2011. [DOI: 10.4132/koreanjpathol.2011.45.6.632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Sung Hak Lee
- Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Chang Young Yoo
- Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ji Han Jung
- Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jin Young Yoo
- Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Suk Jin Kang
- Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Chang Suk Kang
- Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea
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Shadel BN, Frater JL, Gapp JDG, Hurley MY. Cutaneous and systemic plasmacytosis in an Asian male born in the North American continent: A controversial entity potentially related to multicentric Castleman disease. J Cutan Pathol 2010; 37:697-702. [DOI: 10.1111/j.1600-0560.2009.01372.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Miyagawa-Hayashino A, Matsumura Y, Kawakami F, Asada H, Tanioka M, Yoshizawa A, Mikami Y, Kotani H, Nakashima Y, Miyachi Y, Manabe T. High ratio of IgG4-positive plasma cell infiltration in cutaneous plasmacytosis--is this a cutaneous manifestation of IgG4-related disease? Hum Pathol 2009; 40:1269-77. [PMID: 19386351 DOI: 10.1016/j.humpath.2009.01.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Revised: 01/16/2009] [Accepted: 01/23/2009] [Indexed: 02/06/2023]
Abstract
Cutaneous plasmacytosis is a rare condition affecting middle-aged individuals, characterized by multiple red-brown papules and plaques over the trunk. It has been reported mainly in Japan. The condition is accompanied by polyclonal hypergammaglobulinemia and superficial lymphadenopathy. Lung or retroperitoneal involvement occurs rarely. In the present study, 3 consecutive cases of cutaneous plasmacytosis were observed histologically to have abundant infiltration of IgG4-bearing plasma cells. All 3 were associated with superficial lymphadenopathy, one with interstitial lung involvement showing ground-glass opacity on computed tomography and the others with bone marrow plasmacytosis, showing histologic evidence of more IgG4-positive plasma cells. All 3 had polyclonal hypergammaglobulinemia, one had high serum concentration of IgG4, and all had elevated serum IL-6. The ratios of IgG4+ to IgG+ plasma cells were assessed using skin biopsy specimens with pemphigus (n = 7), discoid lupus erythematosus (n = 5), and morphea (n = 2) (mean ratios, 19%, 0%, and 0%, respectively); we noted the proportion of IgG4-positive plasma cells in cutaneous plasmacytosis (mean, 48%). IgG4-related sclerosing disease is a newly recognized systemic disorder characterized by lymphoplasmacytic infiltration and fibrosis and by a high serum IgG4 level and increased IgG4-positive plasma cells in the tissues. Skin manifestations of this disorder have not been described. Although cutaneous plasmacytosis could be a chronic allergic hypersensitivity reaction, our findings raise the possibility of a relationship in pathogenesis between cutaneous plasmacytosis and IgG4-related sclerosing disease.
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22
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Gilliam AC, Mullen RH, Oviedo G, Bhatnagar R, Smith MK, Patton DF, Rodriguez-Soto J, Mostow E. Isolated benign primary cutaneous plasmacytosis in children: two illustrative cases. ACTA ACUST UNITED AC 2009; 145:299-302. [PMID: 19289761 DOI: 10.1001/archdermatol.2008.596] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Plasma cells are normally found in bone marrow and the intestinal tract. They appear in the skin in malignant conditions, autoimmune diseases, infection, and idiopathic and poorly understood disorders such as primary nodular amyloidosis. It is uncommon to find collections of plasma cells in the skin in the absence of these conditions. OBSERVATIONS We present 2 cases of cutaneous plasmacytosis, one in a white, female adolescent aged 15 years with an 11-year history of a solitary, asymptomatic, violaceous plaque on the left anterior tibia and the other in a white, male child aged 7 years with a 2-year history of a solitary erythematous plaque on the right anterior tibia. In both patients, infiltration of mature polyclonal plasma cells was confined to an area on the skin with papulonodules. There was no history of previous trauma, malignant conditions, autoimmune disease, or infection in either child. CONCLUSION Although incipient or occult systemic disease cannot be definitively ruled out, the course of these 2 individuals suggests that isolated primary cutaneous plasmacytosis in children is a benign chronic process with no adverse sequelae.
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Affiliation(s)
- Anita C Gilliam
- Dermatology, Palo Alto Medical Clinic, 795 El Camino Real, Palo Alto, CA 94301, USA.
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23
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MA HJ, LIU W, LI Y, ZHAO G, MENG RS, LI DG. Cutaneous and systemic plasmacytosis: A Chinese case. J Dermatol 2008; 35:536-40. [DOI: 10.1111/j.1346-8138.2008.00516.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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24
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Ahmed B, Tschen JA, Cohen PR, Zaki MH, Rady PL, Tyring SK, Corringham RE, Kurzrock R. Cutaneous castleman's disease responds to anti interleukin-6 treatment. Mol Cancer Ther 2007; 6:2386-90. [PMID: 17766835 DOI: 10.1158/1535-7163.mct-07-0256] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Castleman's disease is uncommon, and cutaneous involvement is even rarer. We report a 42-year-old Asian woman with the multicentric plasma cell variant of Castleman's disease limited to her skin. The literature suggests that Castleman's disease is driven by interleukin-6 (IL-6). Based on these data, we hypothesized that suppression of IL-6 would have a salutary effect. Therefore, our patient was treated with CNTO328, a chimeric murine anti-human IL-6 antibody. She has shown a remarkable, ongoing response to this treatment, with almost complete clearing of her skin lesions after six doses.
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Affiliation(s)
- Bilal Ahmed
- Phase I Program, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Box 422, Houston, TX 77030, USA.
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25
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Kayasut K, Le Tourneau A, Rio B, Bost-Bezeaud F, Heuberger L, Diebold J, Audouin J. Are multicentric Castleman's disease with cutaneous plasmacytosis and systemic plasmacytosis the same entity? Histopathology 2006; 49:557-8. [PMID: 17064311 DOI: 10.1111/j.1365-2559.2006.02532.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Leonard AL, Meehan SA, Ramsey D, Brown L, Sen F. Cutaneous and systemic plasmacytosis. J Am Acad Dermatol 2006; 56:S38-40. [PMID: 17097369 DOI: 10.1016/j.jaad.2006.05.019] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2006] [Revised: 05/05/2006] [Accepted: 05/22/2006] [Indexed: 11/29/2022]
Affiliation(s)
- Aimee L Leonard
- New York University School of Medicine, Department of Dermatology, NY 10128, USA.
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27
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KANEDA M, KURODA K, FUJITA M, SHINKAI H. Successful treatment with topical PUVA of nodular cutaneous plasmacytosis associated with alopecia of the scalp. Clin Exp Dermatol 2006. [DOI: 10.1111/j.1365-2230.1996.tb00124.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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28
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Abstract
Cutaneous plasmacytosis is a rare disorder that typically affects middle-aged to older individuals of Asian, particularly Japanese, descent. Clinically, it is characterized by multiple asymptomatic red-brown plaques and nodules on the trunk. Lymphadenopathy and hypergammaglobulinemia may be present. Histologically, the lesions show a moderately dense superficial and deep perivascular infiltrate composed predominantly of mature plasma cells without atypia or light chain restriction. We report our experience with five additional cases, including results of immunohistochemical studies for human herpes virus 8.
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Affiliation(s)
- Anu G Jayaraman
- Department of Pathology, Stanford University, Stanford, CA 94305-5324, USA
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29
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Martín JM, Calduch L, Monteagudo C, Molina I, Ramón D, Alonso V, Jordá E. Cutaneous plasmacytosis associated with lung and anal carcinomas. J Eur Acad Dermatol Venereol 2006; 20:428-31. [PMID: 16643141 DOI: 10.1111/j.1468-3083.2006.01433.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cutaneous plasmacytosis is a rare disorder characterized by a benign proliferation of mature plasma cells that appears as multiple dark-brown to purplish skin lesions, often associated with polyclonal hypergammaglobulinaemia. We present the case of a 55-year-old Caucasian man who suffered from a cutaneous plasmacytosis associated with two different carcinomas. Cutaneous plasmacytosis seems to be a reactive process because most cases reported are not associated with any apparent underlying disease. Nevertheless, because few reported cases were associated with malignancies, screening of additional neoplasms would be justified.
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Affiliation(s)
- J M Martín
- Department of Dermatology, Hospital Clínico Universitario, Valencia, Spain.
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30
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Fukuzawa M, Yamaura M, Uhara H, Saida T. Systemic plasmacytosis with aseptic bone necrosis and high fever. J Dermatol 2004; 31:696-8. [PMID: 15492448 DOI: 10.1111/j.1346-8138.2004.tb00581.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Amin HM, McLaughlin P, Rutherford CJ, Abruzzo LV, Jones D. Cutaneous and systemic plasmacytosis in a patient of Asian descent living in the United States. Am J Dermatopathol 2002; 24:241-5. [PMID: 12140441 DOI: 10.1097/00000372-200206000-00009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cutaneous and systemic plasmacytosis is a rare disorder characterized by widely disseminated macular skin eruptions composed of polyclonal lymphoplasmacytic infiltrates associated with variable extracutaneous involvement. Previous reports have been largely restricted to the Japanese literature. We present the first documented case of cutaneous and systemic plasmacytosis in a patient residing in the United States. This 49-year-old man, who had immigrated from Korea 19 years earlier, developed innumerable persistent pink-to-brown macular lesions over his trunk and face. Initial and repeat skin biopsy specimens revealed dense perivascular and periadnexal infiltrates of mature plasma cells, and polyclonal plasmacytosis noted on two different biopsy specimens of mildly enlarged lymph nodes. Multiple tiny pulmonary nodules were found to be of the same histologic appearance. No evidence of clonal immunoglobulin gene rearrangements or human herpesvirus type 8 infection was noted in these biopsy specimens. Treatment with antibiotics, systemic chemotherapy, and anti-CD20 antibody therapy failed to eradicate these lesions, which have persisted for 6 years. This case demonstrates that cutaneous and systemic plasmacytosis can arise in a patient of Asian ancestry, even many years after emigration to the United States.
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Affiliation(s)
- Hesham M Amin
- Departments of Hematopathology, The University of Texas-M.D. Anderson Cancer Center, Houston, Texas 77030, U.S.A
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32
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Gómez de la Fuente E, Vanaclocha Sebastián P, Ortiz Romero PL, Rodríguez-Peralto JL, Ortiz de Frutos J, Iglesias Díez L. [Multicentric Castleman disease versus systemic/cutaneous plasmacytosis, 2 different names for the same process?]. Rev Clin Esp 2000; 200:275-8. [PMID: 10901006 DOI: 10.1016/s0014-2565(00)70628-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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33
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Okada H, Kano R, Watanabe S. Lack of evidence of human herpesvirus 8 DNA sequences in HIV-negative patients with systemic plasmacytosis. Br J Dermatol 1999; 141:942-3. [PMID: 10583194 DOI: 10.1046/j.1365-2133.1999.03185.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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34
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Gookin JL, Sellon RK, McDorman KS, Geoly FJ. Systemic plasmacytosis and polyclonal gammopathy in a dog. J Vet Intern Med 1998; 12:471-4. [PMID: 9857341 DOI: 10.1111/j.1939-1676.1998.tb02152.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- J L Gookin
- Department of Companion Animal and Special Species Medicine, College of Veterinary Medicine, North Carolina State University, Raleigh
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35
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Kanbe N, Kurosawa M, Akimoto S, Sugiyama D, Tamura J, Hirao Y, Miyachi Y. Systemic plasmacytosis with deposition of interleukin (IL)-6 and elevated expression of IL-6 mRNA in the skin lesions. Br J Dermatol 1998; 138:721-3. [PMID: 9640399 DOI: 10.1046/j.1365-2133.1998.02206.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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36
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Carey WP, Rico MJ, Nierodzik M, Sidhu G. Systemic plasmacytosis with cutaneous manifestations in a white man: successful therapy with cyclophosphamide/prednisone. J Am Acad Dermatol 1998; 38:629-31. [PMID: 9555807 DOI: 10.1016/s0190-9622(98)70131-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- W P Carey
- Department of Dermatology, New York University Medical Center, New York, USA
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37
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Inaoki M, Takehara K. Increased serum levels of interleukin (IL)-5, IL-6 and IL-8 in bullous pemphigoid. J Dermatol Sci 1998; 16:152-7. [PMID: 9459128 DOI: 10.1016/s0923-1811(97)00044-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Some cytokines have been suggested to take part in the blister formation in bullous pemphigoid (BP). However, the roles of the cytokines are only partly understood. To elucidate the involvement of cytokines in the immunological mechanisms in BP, we investigated the serum levels of interleukin (IL)-2, IL-4, IL-5, IL-6, IL-8, IL-13, soluble IL-2 receptor and soluble CD23 in patients with BP, and the correlation between cytokine levels and other clinical and laboratory data. Serum levels of these cytokines and soluble receptors were determined by enzyme-linked immunosorbent assay in 19 patients with BP and in 16 normal control subjects. Serum levels of IL-5 (P < 0.0001), IL-6 (P < 0.01) and IL-8 (P < 0.05) were significantly higher in BP patients than in the control subjects. Other cytokines and soluble receptor levels were not significantly different. Serum levels of IL-6 (P < 0.05) and IL-8 (P < 0.05) were significantly decreased after treatment when skin lesions disappeared. These results suggest that serum levels of IL-6 and IL-8 could be indicators of disease activity of BP.
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Affiliation(s)
- M Inaoki
- Department of Dermatology, Kanazawa University School of Medicine, Japan
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38
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Yamamoto T, Katayama I, Nishioka K. Increased plasma interleukin-6 in cutaneous plasmacytoma: the effect of intralesional steroid therapy. Br J Dermatol 1997; 137:631-6. [PMID: 9390345 DOI: 10.1111/j.1365-2133.1997.tb03801.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Cutaneous plasmacytosis is a rare disorder without systemic plasma cell proliferation in organs other than the skin, with a possible malignant transformation. However, there are few effective therapies available. It has been reported that interleukin-6 (IL-6), which is a cytokine inducing B-cell differentiation to immunoglobulin-producing cells, plays a part in systemic plasmacytosis. In this study, we performed intralesional steroid therapy in the lesions of cutaneous plasmacytosis in three patients, which resulted in sufficient clinical effects. We demonstrated that before treatment, plasma IL-6 levels were significantly elevated in all the patients, and that levels were reduced in parallel with the clinical improvement after therapy. Immunohistochemistry revealed IL-6 protein expression on tumour cells in the lesional skin. Reverse transcription-polymerase chain reaction (RT-PCR) detected IL-6 mRNA in the lesional skin in all cases, levels of which were decreased after the effective intralesional steroid therapy, but which were unchanged after ineffective topical photochemotherapy (PUVA). Peripheral blood mononuclear cells from the patients produced significantly large quantities of IL-6 which were reduced by addition of steroid in vitro. These results suggest that the generation of IL-6 plays the key role in cutaneous plasmacytosis and that intralesional steroid therapy is effective in reducing the production of IL-6 in this disorder.
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Affiliation(s)
- T Yamamoto
- Department of Dermatology, Tokyo Medical and Dental University School of Medicine, Japan
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39
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Nitta Y. Case of malignant lymphoma associated with primary systemic plasmacytosis with polyclonal hypergammaglobulinemia. Am J Dermatopathol 1997; 19:289-93. [PMID: 9185918 DOI: 10.1097/00000372-199706000-00016] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Systemic plasmacytosis (SP), which has a histologic appearance similar to that of multicentric Castleman's disease (MCD), is also known as benign plasma cell proliferation with polyclonal hypergammaglobulinemia, cutaneous plasmacytosis, and/or generalized plasmacytic lymphadenopathy. The prognosis of SP reportedly has been good. A 59-year-old Japanese man was treated for multiple cutaneous lesions of his trunk as well as polyclonal hypergammaglobulinemia. A skin biopsy showed infiltration of lymphocytes and polyclonal plasma cells in the dermis. The patient developed enlarged superficial lymph nodes 5 years later, and T-cell lymphoma, diffuse mixed type, was diagnosed. At that time, his cutaneous plasmacytosis remained but the polyclonal hypergammaglobulinemia had resolved. Ours is the first reported case of SP to be complicated by the development of T-cell lymphoma.
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Affiliation(s)
- Y Nitta
- Department of Dermatology, Aichi Medical University, Japan
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40
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Shimizu S, Tanaka M, Shimizu H, Han-yaku H. Is cutaneous plasmacytosis a distinct clinical entity? J Am Acad Dermatol 1997; 36:876-80. [PMID: 9146573 DOI: 10.1016/s0190-9622(97)70046-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We describe a Japanese patient with cutaneous plasmacytosis whose clinical course we observed for 5 years. We also review 26 patients with this condition, including 24 Japanese and two non-Japanese, reported in detail. This review revealed that this condition has characteristic clinical and pathologic features and should be considered a distinct clinical entity. The reason for the predominant occurrence of cutaneous plasmacytosis in Japanese patients is unknown.
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Affiliation(s)
- S Shimizu
- Division of Dermatology, Ogikubo Hospital, Tokyo, Japan
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41
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Abstract
Plasmacytosis, a distinctive proliferative disorder of plasma cells, is characterized by peculiar multiple skin eruptions, lymphadenopathy and polyclonal hypergammaglobulinemia. To date there has been no report of such cases showing remarkable responses to therapeutic agents. We herein report a case of plasmacytosis which developed in a 52-year-old Korean man and showed remarkable improvement with melphalan.
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Affiliation(s)
- D W Lee
- Department of Dermatology, Catholic University Medical College, Seoul, Korea
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42
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López-Estebaranz JL, Rodriguez-Peralto JL, Ortiz Romero PL, Vanaclocha F, Iglesias Díez L. Cutaneous plasmacytosis: report of a case in a white man. J Am Acad Dermatol 1994; 31:897-900. [PMID: 7962744 DOI: 10.1016/s0190-9622(94)70255-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We describe a 40-year-old white man with a peculiar skin eruption in association with polyclonal hypergammaglobulinemia. No underlying disease was detected. A skin biopsy specimen showed a proliferation of mature plasma cells intermingled with some lymphocytes and histiocytes, an appearance consistent with cutaneous plasmacytosis. This disease had been previously described only in Japanese patients. In our patient the disease progressed slowly. Lymph node infiltration by mature plasma cells was later noted.
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