Paraneoplastic Scleroderma-Like Tissue Reactions in the Setting of an Underlying Plasma Cell Dyscrasia

Abstract

In any older patient presenting with a sudden onset of eosinophilic fasciitis or scleroderma especially with acral accentuation, investigations should be conducted in regards to an underlying plasma cell dyscrasia.

Morphea associated with primary biliary cirrhosis and Waldenstrom macroglobulinemia: Response to rituximab

“…Disorders of skin fibrosis have been reported in 20 patients with plasma cell dyscrasias (Table II),15, 16, 17, 18, 19, 20, 22 with only 1 case report documenting a relationship between morphea and WM 3 . In patients with monoclonal gammopathies, findings suggest that a circulating plasma cell–derived factor induces fibroblast proliferation, matrix synthesis, and collagen deposition 3 .…”

“…In patients with monoclonal gammopathies, findings suggest that a circulating plasma cell–derived factor induces fibroblast proliferation, matrix synthesis, and collagen deposition 3 . Neoplastic plasma cells may also bind to stromal cells, up-regulating transforming growth factor-β expression and promoting collagen production 22 …”

“…Neoplastic plasma cells may also bind to stromal cells, up-regulating transforming growth factor-β expression and promoting collagen production 22 Table IIMorphea associated with plasma cell dyscrasias in the literatureCaseAuthor/year of publicationSex/age of patientDiagnosisPlasma cell dyscrasia1Magro et al, 2013 3 F/61MorpheaWM2Magro et al, 2013 3 F/68EFMM3Magro et al, 2013 3 M/61MorpheaMGUS4Magro et al, 2013 3 F/60SSMM5Magro et al, 2013 3 F/70MorpheaPOEMS/MZL lung6Magro et al, 2013 3 F/77SSMGUS7Magro et al, 2013 3 F/83EFMGUS8Magro et al, 2013 3 F/61EFMGUS9Magro et al, 2013 3 F/63EFMGUS10Magro et al, 2013 3 M/85EF/SSMM11Reyes et al, 2008 15 F/31SSMM12Paredes-Suarez et al, 2005 16 M/69SSMGUS13Bachleitner-Hoffman et al, 2002 17 F/73EF progressing to SSMGUS14Nakanishi et al, 1989 18 M/50EFMM15Jablonska and Stachow, 1972 19 M/45MorpheaMM16Khanna et al, 2002 20 F/48EFMM17Endo et al, 2016 21 F/68MorpheaMGUS18Endo et al, 2016 21 F/58…”

“…Moreover, scleroderma-like tissue reactions are described in both solid-organ malignancies and plasma cell dyscrasias 2 ; yet only 1 case report details an association between morphea and Waldenstrom macroglobulinemia (WM) 3 . Here we describe a patient with PBC, WM, and recalcitrant morphea who responded to bendamustine-rituximab chemotherapy.…”

Quoi de neuf en dermatologie clinique ?

“…Les auteurs évoquent un effet autocrine ou paracrine des plasmocytes tumoraux avec un rôle brosant. Ces cas, dont le premier décrit en 1972 par Jablonska, rappellent qu'une recherche de gammapathie monoclonale peut être justi ée devant certaines sclérodermies [42]. : 0,4).…”