Case of isolated benign primary cutaneous plasmacytosis in a child

Abstract

A collection of plasma cells in the skin can represent a broad spectrum of disease entities. Secondary syphilis, primary cutaneous plasmacytoma, primary cutaneous plasmacytosis, cutaneous lymphoid hyperplasia and nodular amyloidosis are considered possible differential diagnoses. We present a case of a 7-year-old girl with an erythematous scaly plaque on her right buttock that had been present for approximately 5 years. Prior to her visit to our department she had been treated at a local dermatology clinic with topical methylprednisolone acetate and topical calcitriol without significant improvement. Histopathological examination revealed psoriasiform hyperplasia, hyperkeratosis, parakeratosis and a band-like or dense perivascular infiltration of plasma cells with a few lymphocytes and histiocytes. Other laboratory tests were within the reference ranges. At our department, the patient was given oral prednisolone along with an intralesional injection of triamcinolone and application of topical methylprednisolone acetate and tacrolimus hydrate to the affected area. The lesion improved significantly but recurred 3 months later. We present a rare case of isolated benign primary cutaneous plasmacytosis in a female pre-adolescent child.

Kutane und systemische Plasmozytose

“…Alle 41 von Uhara et al erfassten Patienten waren Japaner [9]. Darüber hinaus sind ganz vereinzelt Chinesen, Koreaner und Thailänder betroffen gewesen [5,6,10,17,18]. Weltweit ist die KSP bis heute nur bei etwa 10 weißen Patienten beschrieben worden [12].…”

“…Bei der Mehrzahl entwickelte sich die KSP zwischen der dritten und fünften Lebensdekade [9,18]. In Einzelfällen konnte die Erkrankung bereits im Kindesalter beobachtet werden [10,12,15] …”

“…Weitere histopathologische Differenzialdiagnosen mit einem polyklonalen Infi ltrationsmuster sind die B-Zell-Pseudolymphome und der multizentrische Morbus Castleman sowie bei Infektionen die kutanen Manifestationen der Syphilis und der Borreliose. Auch Kollagenosen, insbesondere die Morphea, seltener der Lupus erythematodes, sind bisweilen zu berücksichtigen [5,10,11,19,20].…”

“…Bei fehlenden klinischen und sonomorphologischen Nachweisen einer Lymphadenopathie haben zahlreiche Autoren die von ihnen beobachteten Fälle als kutane Plasmozytose eingeordnet [9][10][11]20]. Unauffällige Befunde in den bildgebenden Verfahren schließen eine Plasmazellinfi ltration in den Lymphknoten jedoch nicht aus.…”

Translational Research in Pediatrics IV: Solid Tissue Collection and Processing

“…• Chagas disease 35 • Quilty effect, rejection, C myocarditis reactivation, fi brosis, hypertrophy, and ischemia; as well as lymphocytic cellular infi ltration of myocarditis 35 • Cardiovascular development 167,168 • Morphology and mechanical properties of the atrial intima 167 • Acquired immune defi ciency syndrome 204 • CD4+ T-cell 2 count and HIV viral load, fecal calprotectin, and bowel ultrasound, with the latter evaluating bowel wall thickness and mesenteric lymph nodes 204 Bone marrow PCR, PCR-RFLP, histologic evaluation (Giemsa staining), bone marrow culture 205 • Visceral leishmaniasis 205 • Leishmania DNA 205 Skin Histologic evaluation (H&E), immunoperoxidase 206 • Primary cutaneous plasmacytosis 206 • Search for cell infi ltration of dermis, clusters of B-lymphocytes CD20 reactive, and expression of κ light chains and λ light chains to diagnosis rare disease 206 • Exposure to endocrine disruptors during pregnancy and infancy 189 • Levels of non-POPs (including MEHP, OP, and 4-NP), and PBDEs 189 …”