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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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António AM, Alves JV, Coelho R, Bártolo E. Solitary ulcerated plaque on the face - an unusual presentation of cutaneous plasmacytosis? An Bras Dermatol 2017; 92:410-412. [PMID: 29186262 PMCID: PMC5514590 DOI: 10.1590/abd1806-4841.20175355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 02/21/2016] [Indexed: 02/08/2023] Open
Abstract
Cutaneous and systemic plasmacytosis is a rare disorder characterized by
cutaneous polyclonal plasma cell infiltration frequently associated with
polyclonal hypergammaglobulinemia and lymphadenopathy. We report a case of a
67-year-old woman with an inflammatory ulcerated plaque in the left masseter
region. A skin biopsy showed dense perivascular infiltrate of mature plasma
cells in the dermis without atypia and immunoglobulin light chain restriction.
After physical examination and further investigation, we ruled out systemic
disease. Our patient was successfully treated only with hydrocortisone cream
application. Few cases of isolated benign primary cutaneous plasmacytosis have
been described, particularly in children. After excluding the diagnosis of a
reactive process to an infection, which is unlikely in this case, we suspected
of a rare manifestation of primary cutaneous plasmacytosis in adults with
distinct presentation and clinical course.
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Affiliation(s)
- Ana Marta António
- Dermatovenereology Service, Hospital Garcia de Orta - Almada, Portugal
| | - João Vitor Alves
- Dermatovenereology Service, Hospital Garcia de Orta - Almada, Portugal
| | - Ricardo Coelho
- Dermatology Service, Centro Hospitalar Conde de São Januário - Macau, China
| | - Elvira Bártolo
- Dermatovenereology Service, Hospital Garcia de Orta - Almada, Portugal
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Mok ZR, Tan EST, Chong WS. Treatment of cutaneous plasmacytosis with mask-bath PUVA: A therapeutic option. Australas J Dermatol 2015; 58:e1-e4. [DOI: 10.1111/ajd.12360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 05/08/2015] [Indexed: 12/12/2022]
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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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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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Chantachaeng W, Chularojanamontri L. Cutaneous plasmacytosis: a case report and review of pulmonary findings. Dermatol Reports 2011; 3:e39. [PMID: 25386291 PMCID: PMC4211499 DOI: 10.4081/dr.2011.e39] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 09/12/2011] [Indexed: 01/08/2023] Open
Abstract
Primary cutaneous plasmacytosis is an uncommon cutaneous disorder with multiple cutaneous nodules and plaques mainly on face and trunk. This entity is thought to be a reactive process with unknown etiology. Pulmonary involvement could be found as a part of systemic plasmacytosis whereas cutaneous plasmacytosis was also reported with other pulmonary disorders. This report presents the case of cutaneous plasmacytosis and the review of pulmonary findings reported in plasmacytosis.
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Affiliation(s)
- Weeranut Chantachaeng
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Leena Chularojanamontri
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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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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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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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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