Case and Research Letters
Cutaneous Infiltration due to Waldenström Macroglobulinemia
Infiltración cutánea por macroglobulinemia de Waldenström
Read
6992
Timeswas read the article
2424
Total PDF
4568
Total HTML
Share statistics
array:24 [ "pii" => "S1578219017303712" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.11.015" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "1704" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2017" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2018;109:75-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 313 "formatos" => array:3 [ "EPUB" => 22 "HTML" => 203 "PDF" => 88 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731017302727" "issn" => "00017310" "doi" => "10.1016/j.ad.2017.04.021" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "1704" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2018;109:75-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 195 "formatos" => array:3 [ "EPUB" => 5 "HTML" => 136 "PDF" => 54 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científico-clínica</span>" "titulo" => "Infiltración cutánea por macroglobulinemia de Waldenström" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "75" "paginaFinal" => "78" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cutaneous Infiltration due to Waldenström Macroglobulinemia" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 898 "Ancho" => 1600 "Tamanyo" => 161711 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">a) Placas eritematodescamativas en tórax y flancos. Presentación inicial. b) Curación de las lesiones cutáneas al mes de finalizar el tratamiento quimioterápico.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Oscoz-Jaime, A.D. Agulló-Pérez, C. Llanos-Chavarri, J.I. Yanguas-Bayona" "autores" => array:4 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Oscoz-Jaime" ] 1 => array:2 [ "nombre" => "A.D." "apellidos" => "Agulló-Pérez" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Llanos-Chavarri" ] 3 => array:2 [ "nombre" => "J.I." "apellidos" => "Yanguas-Bayona" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219017303712" "doi" => "10.1016/j.adengl.2017.11.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017303712?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017302727?idApp=UINPBA000044" "url" => "/00017310/0000010900000001/v1_201801020548/S0001731017302727/v1_201801020548/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219017303724" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.11.016" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "1724" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2018;109:78-80" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 493 "formatos" => array:3 [ "EPUB" => 22 "HTML" => 393 "PDF" => 78 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Lupus Erythematosus Affecting the Genitalia: An Unusual Site" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "78" "paginaFinal" => "80" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lupus eritematoso con afectación genital: una localización inusual" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1014 "Ancho" => 1800 "Tamanyo" => 466818 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Bilateral ulcers at the introitus and on the labia minora. B, Epidermis with focal ulceration, foci of parakeratosis, and marked vacuolar degeneration of the basal layer, with necrotic keratinocytes and a chronic inflammatory infiltrate in the superficial dermis. Hematoxylin and eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×200.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. del Alcázar-Viladomiu, A. López-Pestaña, A. Tuneu-Valls" "autores" => array:3 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "del Alcázar-Viladomiu" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "López-Pestaña" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Tuneu-Valls" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731017303150" "doi" => "10.1016/j.ad.2017.05.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017303150?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017303724?idApp=UINPBA000044" "url" => "/15782190/0000010900000001/v1_201801020547/S1578219017303724/v1_201801020547/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219017304018" "issn" => "15782190" "doi" => "10.1016/j.adengl.2016.12.027" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "1606" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2018;109:74" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 231 "formatos" => array:3 [ "EPUB" => 17 "HTML" => 158 "PDF" => 56 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Dermatology</span>" "titulo" => "Male breast cancer mimicking melanoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "74" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cancer de mama en un varón simulando un melanoma" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 995 "Ancho" => 1333 "Tamanyo" => 191248 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "T. Kueder Pajares, A.J. García Malinis, P. Manchado López" "autores" => array:3 [ 0 => array:2 [ "nombre" => "T." "apellidos" => "Kueder Pajares" ] 1 => array:2 [ "nombre" => "A.J." "apellidos" => "García Malinis" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Manchado López" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0001731017300625" "doi" => "10.1016/j.ad.2016.12.016" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017300625?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017304018?idApp=UINPBA000044" "url" => "/15782190/0000010900000001/v1_201801020547/S1578219017304018/v1_201801020547/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Cutaneous Infiltration due to Waldenström Macroglobulinemia" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor</span>:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "75" "paginaFinal" => "78" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "S. Oscoz-Jaime, A.D. Agulló-Pérez, C. Llanos-Chavarri, J.I. Yanguas-Bayona" "autores" => array:4 [ 0 => array:4 [ "nombre" => "S." "apellidos" => "Oscoz-Jaime" "email" => array:1 [ 0 => "saioaoscoz@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A.D." "apellidos" => "Agulló-Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Llanos-Chavarri" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "J.I." "apellidos" => "Yanguas-Bayona" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona (Navarra), Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Complejo Hospitalario de Navarra, Pamplona (Navarra), Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Infiltración cutánea por macroglobulinemia de Waldenström" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1558 "Ancho" => 1500 "Tamanyo" => 615539 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Perivascular lymphoplasmacytic infiltrates around the superficial and deep plexuses. Hematoxylin and eosin (H&E), original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2. B, Periglandular lymphoplasmacytic infiltrates. H&E, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>40. C, Positivity for CD20 in the lymphoplasmacytic infiltrate. CD20 immunohistochemical stain, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10. D, Negativity for CD38 in the neoplastic infiltrate. The few plasma cells that are present are not monoclonal cells and are positive for CD38. CD38 immunohistochemical stain, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Infiltration of the skin by lymphoplasmacytic cells is very rare in Waldenström macroglobulinemia (WM).<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A 73-year-old man was diagnosed with WM in 2011 after investigation for anemia and monocytosis detected in a routine blood test. At the time of diagnosis, he presented massive bone marrow infiltration by lymphoplasmacytic cells, accounting for more than 45% of the total cell count, with λ/κ light chain restriction and a monoclonal immunoglobulin (Ig) M component in blood of 3.84<span class="elsevierStyleHsp" style=""></span>g/dL (normal value<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>2.7<span class="elsevierStyleHsp" style=""></span>g/dL). Study of the L265P mutation in exon 5 of gene <span class="elsevierStyleItalic">MYD88</span> (3p22.2) was positive.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The metastatic work-up showed axillary, retroperitoneal, iliac, and inguinal lymphadenopathies and hepatosplenomegaly. The patient did not report symptoms suggestive of hyperviscosity, and adipose tissue biopsy was negative for amyloid. It was therefore decided to adopt a wait-and-see approach.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In September 2014, the patient was seen in dermatology for the appearance of asymptomatic erythematous plaques with mild desquamation on his upper trunk, back, and face (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). Histology revealed a lymphoplasmacytic infiltrate suggestive of B-cell lymphoma (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>, A and B), predominantly positive for CD20 (with a 2:1 ratio with CD3) and negative for CD38 and CD138 (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>, C and D). The few associated plasma cells did not show λ/κ light chain restriction. Genetic analysis identified positive monoclonal IgH (FR1 region) and biclonal IgH (FR3 region) rearrangements, confirming the diagnosis as cutaneous infiltration by lymphoplasmacytic lymphoma/WM. Immunohistochemistry for IgM was not performed on the skin biopsy because that study is not available at our hospital.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Clinical progression (asthenia, joint pain, weight loss, sweating) was observed during 2015, with progressive anemia (hemoglobin<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>g/dL) and an increase in the size of the previously present lymph nodes. It was therefore decided to start systemic treatment with 6 cycles of rituximab plus bendamustine at standard doses. In addition, topical methylprednisolone was prescribed for the skin lesions. A month after completing the chemotherapy regimen, the skin lesions had disappeared. The patient reported an improvement in his general wellbeing, and blood test results (hemoglobin ><span class="elsevierStyleHsp" style=""></span>12<span class="elsevierStyleHsp" style=""></span>g/dL) and radiological findings had improved. At the time of writing, the patient has no general or cutaneous symptoms and continues on follow-up by the hematology department (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B).</p><p id="par0030" class="elsevierStylePara elsevierViewall">WM is a rare B-cell lymphoproliferative disorder of unknown etiology. It is characterized by a proliferation of lymphoplasmacytic cells in the bone marrow and a monoclonal IgM peak in peripheral blood.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Skin involvement occurs in 5% of patients with WM. According to the classification by Libow et al., 2<span class="elsevierStyleHsp" style=""></span>types of skin lesion can develop<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,3</span></a>: neoplastic lesions due to direct infiltration of the skin by the lymphoplasmacytic cells; and nonneoplastic lesions, secondary to the paraproteinemia. The nonneoplastic lesions are more common and are divided into 3 subtypes: those caused by a hyperviscosity syndrome (acral purpura, mucosal bleeding, peripheral edema); those associated with cryoglobulinemia (acral cyanosis, Raynaud phenomenon, cold hypersensitivity, livedo reticularis, leukocytoclastic vasculitis); and those related to the specific paraproteins (IgM bullous dermatosis, macroglobulinemia cutis, and erythematous papules associated with WM).</p><p id="par0040" class="elsevierStylePara elsevierViewall">The neoplastic skin lesions, due to direct infiltration of the skin by the lymphoplasmacytic cells, are less common. Only around 20 cases have been reported in the literature, (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>)<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3–8</span></a> and their diagnosis in daily practice is very rare. They present clinically as mildly desquamating, slightly infiltrated erythematous plaques localized mainly symmetrically on the face and ears and also on the chest, flanks, and back.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3–8</span></a> They can arise early in the course of the disease, but it should be stressed that their presence does not worsen the prognosis. Cells found in these skin lesions are from the lymphoplasmacytic cell line. They are positive for B-cell markers (CD19, CD20, CD22) and negative for plasma cell markers (CD38 and CD138).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The distinction between cases of lymphoplasmacytic lymphoma/WM and marginal zone lymphoma (MZL) with intense plasmacytic differentiation can be difficult in some cases because of the degree of clinical-pathologic overlap. Investigation of cyclin D1 (positive in MZL and negative in skin involvement by WM) and of <span class="elsevierStyleItalic">MYD88</span> gene mutation (somatic mutation L265P is present in the majority of cases of WM<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a>) and t11;18 translocation (present in MZL) can be used to make a definitive diagnosis.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In multiple myeloma, the lesions analogous to the neoplastic lesions of WM are plasmacytomas. These present clinically as erythematous-violaceous or erythematous-yellowish plaques or nodules, and are the result of direct infiltration of the skin from underlying bony foci. Histology reveals a deep dermal and hypodermal infiltrate of plasma cells that are positive for CD38 and CD138 and negative for B-cell markers. In contrast to lesions due to infiltration by WM, the presence of plasmacytomas worsens the prognosis of multiple myeloma.</p><p id="par0055" class="elsevierStylePara elsevierViewall">We draw attention to the peculiarities of our case because direct cutaneous infiltration by the lymphoproliferative disease is relatively rare, based on the literature, and does not lead to a worsening of the prognosis despite being a manifestation of disease progression.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as: Oscoz-Jaime S, Agulló-Pérez AD, Llanos-Chavarri C, Yanguas-Bayona JI. Infiltración cutánea por macroglobulinemia de Waldenström. Actas Dermosifiliogr. 2018;109:75–78.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 898 "Ancho" => 1600 "Tamanyo" => 164140 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Initial presentation: desquamating erythematous plaques on the chest and flanks. B, Healing of the skin lesions a month after completing chemotherapy treatment.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1558 "Ancho" => 1500 "Tamanyo" => 615539 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Perivascular lymphoplasmacytic infiltrates around the superficial and deep plexuses. Hematoxylin and eosin (H&E), original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2. B, Periglandular lymphoplasmacytic infiltrates. H&E, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>40. C, Positivity for CD20 in the lymphoplasmacytic infiltrate. CD20 immunohistochemical stain, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10. D, Negativity for CD38 in the neoplastic infiltrate. The few plasma cells that are present are not monoclonal cells and are positive for CD38. CD38 immunohistochemical stain, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Abbreviations: CHOP, cyclophosphamide<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>doxorubicin<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>vincristine<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>prednisone; F, female; M, male; NP, not performed; NR, not recorded or not performed.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">No. of Cases \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">Mean Age, y \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">Sex, M/F \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">Cutaneous Manifestations \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">Cutaneous Histology<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">Bone Marrow<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">Treatments \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">L265P Mutation in Gene <span class="elsevierStyleItalic">MYD88</span> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">71.31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8/12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Sites of desquamating erythematous-violaceous plaques:<br>Face and auricles of the ears: 13/20<br>Trunk: 7/20<br>Lower limbs: 4/20<br>Upper limbs: 2/20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Lymphoplasmacytic infiltrate in the reticular dermis and hypodermis.<br><br>IgM<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>: 12/20<br>IgM– or NP: 8/20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Positive: 15/20<br>Negative or NR: 5/20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Clorambucil: 9/20<br>Cyclophosphamide: 3/20<br>Vincristine: 3/20<br>Radiotherapy: 2/20<br>CHOP: 2/20<br>Lomustine: 1/20<br>Plasmapheresis: 1/20<br>Rituximab<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>bendamustine: 1/20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NR: 19/20<br>Positive: 1/20 (Oscoz-Jaime et al) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1631802.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Cutaneous histology: IgM in cutaneous histology measured by direct immunofluorescence.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Bone marrow biopsy: Positive indicates consistent with lymphoplasmacytic lymphoma.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Summary of Cases of Skin Involvement by Waldenström Macroglobulinemia Reported in the Literature (See Additional Material).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Macroglobulinemia de Waldenström asociada a lesiones cutáneas y crioglobulinemia tipo I" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Del Olmo" 1 => "A. España" 2 => "M.A. Idoate" 3 => "C. Panizo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr." "fecha" => "2008" "volumen" => "99" "paginaInicial" => "138" "paginaFinal" => "144" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18346436" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Waldenström's macroglobulinemia: What a hematologist needs to know" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Kapoor" 1 => "J. Paludo" 2 => "N. Vallumstela" 3 => "P.R. Greipp" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Blood Review." "fecha" => "2015" "volumen" => "29" "paginaInicial" => "301" "paginaFinal" => "319" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous Waldenström's macroglobulinemia: Report of a case and overview of the spectrum of cutaneous disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L.F. Libow" 1 => "J.P. Mawhinney" 2 => "G.T. Bassinger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "2001" "volumen" => "45" "paginaInicial" => "202" "paginaFinal" => "206" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous manifestations as initial presentation of Waldenström's macroglobulinemia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Abdallah-Loft" 1 => "C. Bourgeois-Droin" 2 => "V. Perronne" 3 => "N. Fouchard" 4 => "S. Michel" 5 => "E. Launay-Russ" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Dermatol." "fecha" => "2003" "volumen" => "13" "paginaInicial" => "90" "paginaFinal" => "92" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12609792" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Localisations cutanées de la maladie de Waldenström" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Mantoux" 1 => "J. Castanet" 2 => "C. Perrin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Dermatol Venereol." "fecha" => "2002" "volumen" => "129" "paginaInicial" => "53" "paginaFinal" => "55" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11937931" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous Waldenström's macroglobulinemia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "I. Chan" 1 => "E. Calonje" 2 => "S.J. Whittaker" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Exp Dermatol." "fecha" => "2003" "volumen" => "28" "paginaInicial" => "491" "paginaFinal" => "492" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12950334" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Specific cutaneous manifestations of Waldenstrom's macroglobulinemia. A report of two cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Mascaro" 1 => "E. Montserrat" 2 => "T. Estrach" 3 => "E. Feliu" 4 => "J. Ferrando" 5 => "T. Castel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol." "fecha" => "1982" "volumen" => "106" "paginaInicial" => "217" "paginaFinal" => "222" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6800395" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Localisations cutanées spécifiques d’une maladie de Waldenström" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Sigal" 1 => "C. Foldès" 2 => "M. Grossin" 3 => "M.A. Pocidalo" 4 => "F. Basset" 5 => "S. Belaïch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Dermatol Venereol." "fecha" => "1985" "volumen" => "112" "paginaInicial" => "763" "paginaFinal" => "764" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3937478" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Detection of MYD88 L265P in patients with lymphoplasmocytic lymphoma/Waldenstrom macroglobulinemia and other B-cell non-Hodgkin lymphomas" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.Y. Shin" 1 => "S.T. Lee" 2 => "H.Y. Kim" 3 => "C.H. Park" 4 => "J.W. Kim" 5 => "S.J. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5045/br.2016.51.3.181" "Revista" => array:6 [ "tituloSerie" => "Blood Res." "fecha" => "2016" "volumen" => "51" "paginaInicial" => "181" "paginaFinal" => "186" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27722129" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "National Comprehensive Cancer [main page on Internet]. Nodal Marginal Zone Lymphoma. US: Tempero MA; c2017 [21/2/2017]; [accessed 11 mar 2017]; [approx. 31 screens]. Available at: <a href="https://www.nccn.org/professionals/physician_gls/pdf/b-cell.pdf">https://www.nccn.org/professionals/physician_gls/pdf/b-cell.pdf</a>." ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010900000001/v1_201801020547/S1578219017303712/v1_201801020547/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010900000001/v1_201801020547/S1578219017303712/v1_201801020547/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017303712?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 9 | 16 |
| 2024 October | 122 | 53 | 175 |
| 2024 September | 117 | 28 | 145 |
| 2024 August | 124 | 60 | 184 |
| 2024 July | 103 | 44 | 147 |
| 2024 June | 116 | 49 | 165 |
| 2024 May | 107 | 32 | 139 |
| 2024 April | 107 | 35 | 142 |
| 2024 March | 116 | 24 | 140 |
| 2024 February | 91 | 40 | 131 |
| 2024 January | 81 | 33 | 114 |
| 2023 December | 59 | 18 | 77 |
| 2023 November | 89 | 34 | 123 |
| 2023 October | 97 | 33 | 130 |
| 2023 September | 86 | 38 | 124 |
| 2023 August | 65 | 20 | 85 |
| 2023 July | 80 | 43 | 123 |
| 2023 June | 81 | 31 | 112 |
| 2023 May | 96 | 28 | 124 |
| 2023 April | 83 | 24 | 107 |
| 2023 March | 80 | 45 | 125 |
| 2023 February | 69 | 40 | 109 |
| 2023 January | 61 | 50 | 111 |
| 2022 December | 57 | 46 | 103 |
| 2022 November | 54 | 36 | 90 |
| 2022 October | 39 | 33 | 72 |
| 2022 September | 26 | 68 | 94 |
| 2022 August | 21 | 46 | 67 |
| 2022 July | 32 | 32 | 64 |
| 2022 June | 34 | 34 | 68 |
| 2022 May | 78 | 64 | 142 |
| 2022 April | 93 | 56 | 149 |
| 2022 March | 129 | 79 | 208 |
| 2022 February | 130 | 44 | 174 |
| 2022 January | 132 | 42 | 174 |
| 2021 December | 54 | 47 | 101 |
| 2021 November | 77 | 53 | 130 |
| 2021 October | 93 | 64 | 157 |
| 2021 September | 96 | 53 | 149 |
| 2021 August | 86 | 53 | 139 |
| 2021 July | 66 | 49 | 115 |
| 2021 June | 55 | 34 | 89 |
| 2021 May | 91 | 63 | 154 |
| 2021 April | 168 | 99 | 267 |
| 2021 March | 119 | 50 | 169 |
| 2021 February | 109 | 58 | 167 |
| 2021 January | 58 | 36 | 94 |
| 2020 December | 63 | 38 | 101 |
| 2020 November | 59 | 46 | 105 |
| 2020 October | 36 | 23 | 59 |
| 2020 September | 63 | 32 | 95 |
| 2020 August | 45 | 27 | 72 |
| 2020 July | 33 | 22 | 55 |
| 2020 June | 42 | 43 | 85 |
| 2020 May | 21 | 14 | 35 |
| 2020 April | 29 | 18 | 47 |
| 2020 March | 36 | 23 | 59 |
| 2020 February | 4 | 0 | 4 |
| 2020 January | 4 | 0 | 4 |
| 2019 December | 8 | 0 | 8 |
| 2019 November | 4 | 0 | 4 |
| 2019 September | 8 | 0 | 8 |
| 2019 August | 4 | 0 | 4 |
| 2019 July | 4 | 0 | 4 |
| 2019 June | 4 | 0 | 4 |
| 2019 May | 7 | 0 | 7 |
| 2019 April | 2 | 0 | 2 |
| 2019 March | 4 | 0 | 4 |
| 2019 January | 1 | 0 | 1 |
| 2018 December | 6 | 0 | 6 |
| 2018 October | 3 | 0 | 3 |
| 2018 September | 5 | 0 | 5 |
| 2018 February | 64 | 27 | 91 |
| 2018 January | 67 | 36 | 103 |
| 2017 December | 8 | 25 | 33 |
Show all
