Multiple progressive annular telangiectasias: A clinicopathological variant of cutaneous collagenous vasculopathy?

Cutaneous Collagenous Vasculopathy: A Short Case Series and Literature Review

ABSTRACT

Cutaneous collagenous vasculopathy (CCV) is a rare and idiopathic microangiopathy of superficial dermal blood vessels. There have been 75 cases described in the literature to date, not including the current report; however, given its clinical similarity to other primary telangiectasias, it is likely to be underreported and underdiagnosed. Here, we describe the clinical and histological features of 2 patients we newly diagnosed with CCV. Both generally fit the profile of prior cases and confirm previously described associations-they both are older White women, have rashes on their lower extremities, and have conditions and medications that are common among other reported cases. However, both are also somewhat atypical, as Patient 1 had symptomatic CCV and Patient 2 had a papular rash. As such, both cases broaden the spectrum of our current understanding of CCV. We also provide a comprehensive review of all published reports of CCV to date and uncover 2 previously unreported associations: one with visceral malignancy, and the other with hypothyroidism. Whether these association are coincidental is worth investigating in future studies.

A Case of Cutaneous Collagenous Vasculopathy Associated with Multiple Myeloma and with Pathogenic Variant in the Glucocerebrosidase Gene

Cutaneous collagenous vasculopathy (CCV) is an extremely rare acquired microangiopathy of unknown etiology. The authors describe a case of a 68-year-old man, a carrier of a heterozygous pathogenic variant in the glucocerebrosidase (GBA) gene, who was diagnosed with CCV, revealing uncommon fibrinogen positivity in direct immunofluorescence. The patient was subsequently diagnosed with multiple myeloma. The treatment of myeloma with combined chemotherapy including bortezomib, followed by autologous stem cell transplantation, led to significant reduction of cutaneous lesions. To the best of the authors' knowledge, this is the first published case of CCV in a carrier of a pathogenic variant in the GBA gene, associated with multiple myeloma and with significant regression of CCV after the myeloma treatment. Direct immunofluorescence examination revealed uncommon fibrinogen positivity. Hypothetical causative role of bortezomib treatment was proposed regarding significant regression of CCV. This article is protected by copyright. All rights reserved.