Cutaneous Plasmacytosis with Perineural Involvement

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.

Treatment of cutaneous plasmacytosis with mask‐bath PUVA: A therapeutic option

“…13 After two cycles of twice weekly injections no new lesions occurred. Existing lesions had demonstrable signs of regression.…”

Cutaneous plasmacytosis resembling pityriasis rosea in a 66-year-old white woman: A rare disease presenting in an unusual patient demographic

“… 8 Perineural infiltrates and lymphoid follicles with reactive germinal centers are less commonly reported. 9 Immunohistochemistry shows polyclonal plasma cells with the existence of both κ and γ chain positivity.…”

A Rare Case of Cutaneous Plasmacytosis in a Korean Male

“…These plasma cells are typically polyclonal and exhibit little to no atypia [ 1 , 15 ]. Perineural involvement, and even infiltration of the nerve fascicles, is common [ 16 ]. The epidermis is often acanthotic with basal layer hyperpigmentation [ 1 , 3 ].…”