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Chen H, Ba W, Chen H, Yang H. Cutaneous involvement as initial presentation of multicentric plasmacytic Castleman disease. J Cutan Pathol 2021; 48:701-705. [PMID: 33469928 DOI: 10.1111/cup.13964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 01/09/2023]
Abstract
Castleman disease (CD) is an unusual lymphoproliferative disorder characterized by multiple lymphadenopathy accompanied by marked systemic inflammatory symptoms. CD can be unicentric (UCD) or multicentric (MCD), and it can be classified into three types based on histopathology: hyaline vascular type, plasma cell type, and mixed hyaline vascular and plasma cell type. CD involving skin is an unusual clinical manifestation. Abnormalities including rash, hyperpigmentation, cherry hemangiomatosis, paraneoplastic pemphigus, and Kaposi sarcoma have been reported to occur in MCD. Here, we reported an unusual case of MCD which presented initially with disseminated dark brown papules, patches, and plaques, and pathologically demonstrated plasma cell type CD, a finding which is rarely reported. The peculiar clinicopathological features will be discussed.
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Affiliation(s)
- Hongxiao Chen
- Department of Dermatology, Linyi People's Hospital, Shandong, China
| | - Wei Ba
- Department of Dermatology, Chinese PLA General Hospital and Medical School, Beijing, China
| | - Hao Chen
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Hongyu Yang
- Department of Pathology, St. Vincent Evansville Medical Center, Evansville, Indiana, USA
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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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Progressive Hyperpigmented Plaques: Answer. Am J Dermatopathol 2019; 41:862-863. [PMID: 31633553 DOI: 10.1097/dad.0000000000001239] [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]
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4
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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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A Rare Case of Cutaneous Plasmacytosis in a Korean Male. Case Rep Pathol 2017; 2017:3032941. [PMID: 28848684 PMCID: PMC5564110 DOI: 10.1155/2017/3032941] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/10/2017] [Indexed: 11/28/2022] Open
Abstract
Cutaneous and systemic plasmacytosis are reactive disease processes that occur in middle-aged Japanese and Chinese men. Systemic plasmacytosis, defined by plasmacytic infiltration of two organ systems, might rarely progress to lymphoma. Cutaneous plasmacytosis, however, is chronic and benign and is characterized by the development of multiple plasma cell-rich infiltrates in the skin. We present a case of cutaneous plasmacytosis in a 46-year-old Korean male. The patient demonstrated classic features of the disease entity, including disseminated red-brown plaques, differentiated plasmacytoid infiltrates on biopsy, hypergammaglobulinemia, and the absence of systemic disease.
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7
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Fang S, Shan K, Chen AJ. Cutaneous and systemic plasmacytosis on the face: Effective treatment of a case using thalidomide. Oncol Lett 2016; 11:1923-1925. [PMID: 26998101 DOI: 10.3892/ol.2016.4140] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 05/27/2015] [Indexed: 01/01/2023] Open
Abstract
Cutaneous and systemic plasmacytosis is an exceedingly rare condition that is identified in Japanese individuals in particular. The present study describes the case of a patient of mainland Chinese origin who manifested with red-brown macules, papules and plaques limited to the face. Identifying a therapy for cutaneous and systemic plasmacytosis is quite difficult, however, the present patient showed a good response to low-dose thalidomide. The exact mechanism of action is not yet clear, however, we hypothesize that thalidomide may function through decreasing the secretion of interleukin-6 and affecting the growth of plasma cells.
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Affiliation(s)
- Sheng Fang
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Kui Shan
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Ai-Jun Chen
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
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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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López-Gómez A, Salas-García T, Ramírez-Andreo A, Poblet-Martínez E. Plasmocitosis cutánea en un varón de raza blanca. ACTAS DERMO-SIFILIOGRAFICAS 2015; 106:520-2. [DOI: 10.1016/j.ad.2014.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 12/03/2014] [Accepted: 12/04/2014] [Indexed: 10/24/2022] Open
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10
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Cutaneous Plasmacytosis in a White Man. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2015.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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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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12
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Cutaneous plasmacytosis with perineural involvement. Case Rep Dermatol Med 2014; 2014:840845. [PMID: 24839563 PMCID: PMC4006542 DOI: 10.1155/2014/840845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 12/24/2013] [Indexed: 11/21/2022] Open
Abstract
Importance. Cutaneous and systemic plasmacytosis are rare conditions of unknown etiology with characteristic red-brown skin lesions and a mature polyclonal plasma cell infiltrate within the dermis. Perineural plasma cell infiltrates may be a histologic clue to the diagnosis of cutaneous plasmacytosis. Observations. Our patient had a five-year history of persistent reddish-brown plaques on the neck and trunk without systemic symptoms. Histologic examination showed dermal perivascular and perineural plasma cells with excess lambda light chain expression. Due to decreased quality of life caused by his skin lesions, he was placed on a chemotherapeutic regimen with bortezomib. Conclusions and Relevance. The patient was diagnosed with cutaneous plasmacytosis based on classic histopathology results with a recently characterized pattern of perineural involvement. Bortezomib therapy was initiated to manage his skin eruption, which has not been previously described as a treatment for this chronic condition.
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13
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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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Chen Y, Xue R, Huang L, Chen W, Wu T, Pan H. Cutaneous plasmacytosis occurring on the head-face area: a Chinese case. Int J Dermatol 2013; 52:1115-8. [DOI: 10.1111/j.1365-4632.2011.05376.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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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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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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17
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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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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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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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Hafner C, Hohenleutner U, Babilas P, Landthaler M, Vogt T. Targeting T Cells to Hit B Cells: Successful Treatment of Cutaneous Plasmacytosis with Topical Pimecrolimus. Dermatology 2006; 213:163-5. [PMID: 16902298 DOI: 10.1159/000093860] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Accepted: 03/23/2006] [Indexed: 11/19/2022] Open
Abstract
Cutaneous plasmacytosis is a rare disease predominantly found in Japanese patients. We describe the case of a 75-year-old white female with cutaneous plasmacytosis of the face and involvement of the bone marrow. In contrast to other cases of cutaneous plasmacytosis, the patient revealed hypogammaglobulinemia and elevated levels of free light chains in the urine. Treatment with topical pimecrolimus 1%, which primarily targets T cells, led to almost complete clinical and histological remission of the skin lesions. Our report indicates that the therapeutically induced disappearance of the plasma cells was due to indirect T-cell-mediated effects.
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Affiliation(s)
- Christian Hafner
- Klinik und Poliklinik fur Dermatologie, Universitat Regensburg, Germany.
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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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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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