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Se observa un infiltrado linfoplasmocitario perivascular, con hiperqueratosis epidérmica (×<span class="elsevierStyleHsp" style=""></span>20). El detalle muestra que el infiltrado se compone principalmente de células plasmáticas maduras (×<span class="elsevierStyleHsp" style=""></span>40).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. López-Gómez, T. Salas-García, A. Ramírez-Andreo, E. Poblet-Martínez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "López-Gómez" ] 1 => array:2 [ "nombre" => "T." "apellidos" => "Salas-García" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Ramírez-Andreo" ] 3 => array:2 [ "nombre" => "E." 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"apellidos" => "Poblet-Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital General Universitario Reina Sofía, Murcia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital General Universitario Reina Sofía, Murcia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Plasmocitosis cutánea en un varón de raza blanca" ] ] "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" => 1267 "Ancho" => 950 "Tamanyo" => 347424 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histological image of one of the lesions on the back with hematoxylin-eosin staining. Perivascular lymphoplasmacytic infiltrate can be seen with epidermal hyperkeratosis (×<span class="elsevierStyleHsp" style=""></span>20). Inset shows that the infiltrate is composed mainly of mature plasma cells (×<span class="elsevierStyleHsp" style=""></span>40).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 56-year-old man with no relevant history sought medical attention for asymptomatic rash with onset 1 year earlier. The physical examination revealed multiple brown-red papules distributed symmetrically on the trunk, arms, and buttocks (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and1B). The Darier sign was negative and neither hepatosplenomegaly nor swollen lymph nodes could be palpated. In the skin biopsy, a perivascular and periadnexal dermal infiltrate was observed, consisting of monomorphic plasma cells, with no atypia or mitoses, with lymphocytes, and scant mastocytes (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Serum lactase dehydrogenase, beta-2-microglobulin, and tryptase, as well as 24-hour N-methyl-imidazole acetic acid in urine were normal. Serology for syphilis, hepatitis B virus, hepatitis C virus, human immunodeficiency virus, and <span class="elsevierStyleItalic">Borrelia burgdorferi</span> were negative. The Mantoux test was positive, although we later learned that the patient had received antituberculosis treatment in childhood. Levels of serum proteins and electrophoresis were normal. Determination of immunoglobulin (Ig) by centrifugation revealed slightly decreased IgM, with normal levels of IgG, subclasses of IgG, and IgA. We did not detect Bence Jones proteinuria or free light chains in urine. Histochemical study of the second sample showed predominance of plasma cells (CD138+), which expressed both light Ig chains, demonstrating the polyclonality of the infiltrate, and a normal number of mastocytes (ckit+). Congo red staining ruled out the presence of amyloid deposits. In view of the above findings, cutaneous plasmacytosis was diagnosed and a chest-abdominal-pelvic computed tomography study was requested along with bone marrow biopsy, though no signs of extracutaneous infiltration were detected. IL-6 serum was normal, and the polymerase chain reaction assay for human herpes virus-8 (HHV-8) was negative. The patient has been in clinical, laboratory, and radiological follow-up for 2.5 years, during which time he has remained stable without treatment and without spread of the disease.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Cutaneous and systemic plasmacytosis is a rare lymphoplasmacytic disorder of unknown cause, reported mainly in middle-aged Japanese men; 11 cases have been reported in the white population.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–9</span></a> Kimura<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> coined the term cutaneous plasmacytosis, with reference to the exclusively cutaneous infiltration by mature plasma cells. Subsequently, Watanabe<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> reported systemic plasmacytosis with infiltration by mature plasma cells in more than 2 organs (including the skin and lymph nodes) accompanied by polyclonal hypergammaglobulinemia.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Clinically, the condition is characterized by persistent and asymptomatic or mildly itchy multiple macules, papules, plaques, and brown-red nodules, distributed symmetrically on the trunk, face, and proximal part of the limbs, without palmoplantar involvement.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> Simultaneously, or subsequently, extracutaneous manifestations may appear due to infiltration by plasma cells, with enlarged peripheral lymph nodes being the most common finding.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,6,7,10</span></a> Infiltration of bone marrow has also been reported.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6–9</span></a> Other findings of extracutaneous infiltration reported include hepatosplenomegaly, interstitial pneumonia, and nephropathy, though histopathological confirmation was not available in most cases.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4–8</span></a> Patients with systemic involvement can show constitutional symptoms.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3,7–9</span></a> Often, polyclonal hypergammaglobulinemia can appear, mainly of IgG and IgA.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2–10</span></a> Our patient, however, had an IgM deficit that we did not consider to be clinically relevant. Anemia and increased erythrocyte sedimentation rate or total serum proteins have also been reported.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4–9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Histologically, skin lesions are characterized by a periadnexal and perivascular dermal infiltrate of mature, polyclonal plasma cells, without atypia, and with a variable number of lymphocytes and histiocytes, generally without epidermal involvement.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Clinically, involvement on the trunk can be confused with acne, lichen planus, lymphomas, mastocytosis, parapsoriasis, pityriasis rosea or postinflammatory hyperpigmentation, and facial involvement with rosacea or lupus erythematosus.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6,7,9</span></a> Histologically, it is necessary to differentiate this condition from other cutaneous infiltrates of plasma cells such as malignant proliferations which are monoclonal (plasmacytoma, B-cell lymphomas, and leukemia cutis in plasma cell leukemias),<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> connective tissue disorders (morphea, lupus), and infections (syphilis, borreliosis).<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8,9</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Its pathogenesis is unknown. Proliferation of plasma cells seems to be a reactive process, and the higher incidence in Japanese individuals suggests that environmental, genetic, or infectious factors are present.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6,8</span></a> Elevated interleukin (IL) 6 is reported in 75% of patients with cutaneous and systemic plasmacytosis.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> This cytokine induces differentiation of B lymphocytes to plasma cells. IL-6 is also elevated in multicentric Castleman disease (MCD), which has led some authors to consider cutaneous and systemic plasmacytosis as one of its variants. However, generally, this increase in MCD appears to result from HHV-8 infected cells, whereas this virus has not been detected in cutaneous and systemic plasmacytosis.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4,6–9</span></a> Our patient had normal IL-6 serum and negative polymerase chain reaction for HHV-8. It has recently been suggested that IgG<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> could play a role in the pathogenesis of the disease.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6,8</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Cutaneous plasmacytosis normally follows a chronic, benign course, without spontaneous remission, although cases of patients with systemic plasmacytosis who developed respiratory or renal failure and association with certain tumors, such as T-cell lymphoma, have been reported.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,5,7,9</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Multiple treatments have been reported (corticosteroids, topical immunomodulators, antibiotics, psoralen and ultraviolet A radiation, lasers, radiotherapy, thalidomide, immunoglobulins, rituximab, chemotherapy) with limited response.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3,5–9</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">We presented a case of cutaneous plasmacytosis without any evidence of systemic involvement to date. We consider the case of interest given the low incidence of the disease in white individuals.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: López-Gómez A, Salas-García T, Ramírez-Andreo A, Poblet-Martínez E. Plasmocitosis cutánea en un varón de raza blanca. Actas Dermosifiliogr. 2015;106:520–522.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 915 "Ancho" => 1374 "Tamanyo" => 221752 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Multiple papules distributed symmetrically on the trunk and tops of the limbs of the patient. B, Detail of the lesions: rounded or ovulated, nonscaling, nonconfluent brown-red papules with well-defined borders, measuring up to 6<span class="elsevierStyleHsp" style=""></span>mm.</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" => 1267 "Ancho" => 950 "Tamanyo" => 347424 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histological image of one of the lesions on the back with hematoxylin-eosin staining. Perivascular lymphoplasmacytic infiltrate can be seen with epidermal hyperkeratosis (×<span class="elsevierStyleHsp" style=""></span>20). 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año/Mes | Html | Total | |
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2024 Noviembre | 9 | 11 | 20 |
2024 Octubre | 64 | 52 | 116 |
2024 Septiembre | 71 | 34 | 105 |
2024 Agosto | 101 | 62 | 163 |
2024 Julio | 76 | 42 | 118 |
2024 Junio | 78 | 47 | 125 |
2024 Mayo | 69 | 32 | 101 |
2024 Abril | 71 | 36 | 107 |
2024 Marzo | 76 | 31 | 107 |
2024 Febrero | 72 | 32 | 104 |
2024 Enero | 48 | 29 | 77 |
2023 Diciembre | 47 | 17 | 64 |
2023 Noviembre | 71 | 32 | 103 |
2023 Octubre | 80 | 30 | 110 |
2023 Septiembre | 69 | 32 | 101 |
2023 Agosto | 39 | 12 | 51 |
2023 Julio | 78 | 38 | 116 |
2023 Junio | 50 | 18 | 68 |
2023 Mayo | 46 | 26 | 72 |
2023 Abril | 33 | 26 | 59 |
2023 Marzo | 38 | 20 | 58 |
2023 Febrero | 36 | 28 | 64 |
2023 Enero | 44 | 35 | 79 |
2022 Diciembre | 60 | 44 | 104 |
2022 Noviembre | 31 | 24 | 55 |
2022 Octubre | 28 | 17 | 45 |
2022 Septiembre | 25 | 48 | 73 |
2022 Agosto | 19 | 48 | 67 |
2022 Julio | 34 | 33 | 67 |
2022 Junio | 21 | 32 | 53 |
2022 Mayo | 38 | 29 | 67 |
2022 Abril | 58 | 33 | 91 |
2022 Marzo | 66 | 61 | 127 |
2022 Febrero | 35 | 31 | 66 |
2022 Enero | 48 | 36 | 84 |
2021 Diciembre | 40 | 39 | 79 |
2021 Noviembre | 47 | 46 | 93 |
2021 Octubre | 63 | 47 | 110 |
2021 Septiembre | 44 | 32 | 76 |
2021 Agosto | 33 | 29 | 62 |
2021 Julio | 32 | 30 | 62 |
2021 Junio | 32 | 25 | 57 |
2021 Mayo | 39 | 32 | 71 |
2021 Abril | 54 | 47 | 101 |
2021 Marzo | 45 | 13 | 58 |
2021 Febrero | 54 | 27 | 81 |
2021 Enero | 32 | 20 | 52 |
2020 Diciembre | 43 | 25 | 68 |
2020 Noviembre | 27 | 18 | 45 |
2020 Octubre | 42 | 12 | 54 |
2020 Septiembre | 39 | 9 | 48 |
2020 Agosto | 45 | 15 | 60 |
2020 Julio | 34 | 12 | 46 |
2020 Junio | 48 | 28 | 76 |
2020 Mayo | 32 | 21 | 53 |
2020 Abril | 36 | 21 | 57 |
2020 Marzo | 33 | 21 | 54 |
2020 Febrero | 5 | 4 | 9 |
2020 Enero | 4 | 1 | 5 |
2019 Diciembre | 4 | 4 | 8 |
2019 Noviembre | 4 | 1 | 5 |
2019 Octubre | 0 | 1 | 1 |
2019 Agosto | 4 | 3 | 7 |
2019 Julio | 4 | 2 | 6 |
2019 Junio | 3 | 6 | 9 |
2019 Mayo | 5 | 6 | 11 |
2019 Abril | 3 | 9 | 12 |
2019 Marzo | 2 | 3 | 5 |
2019 Febrero | 2 | 0 | 2 |
2019 Enero | 2 | 0 | 2 |
2018 Diciembre | 2 | 0 | 2 |
2018 Noviembre | 1 | 0 | 1 |
2018 Octubre | 3 | 0 | 3 |
2018 Septiembre | 5 | 1 | 6 |
2018 Agosto | 0 | 1 | 1 |
2018 Julio | 0 | 1 | 1 |
2018 Junio | 0 | 2 | 2 |
2018 Marzo | 2 | 1 | 3 |
2018 Febrero | 16 | 2 | 18 |
2018 Enero | 25 | 2 | 27 |
2017 Diciembre | 38 | 11 | 49 |
2017 Noviembre | 23 | 7 | 30 |
2017 Octubre | 16 | 10 | 26 |
2017 Septiembre | 24 | 8 | 32 |
2017 Agosto | 31 | 4 | 35 |
2017 Julio | 22 | 8 | 30 |
2017 Junio | 28 | 11 | 39 |
2017 Mayo | 28 | 8 | 36 |
2017 Abril | 23 | 9 | 32 |
2017 Marzo | 19 | 50 | 69 |
2017 Febrero | 18 | 7 | 25 |
2017 Enero | 18 | 2 | 20 |
2016 Diciembre | 27 | 10 | 37 |
2016 Noviembre | 39 | 8 | 47 |
2016 Octubre | 24 | 13 | 37 |
2016 Septiembre | 0 | 2 | 2 |
2016 Agosto | 0 | 4 | 4 |
2016 Julio | 8 | 2 | 10 |
2016 Junio | 9 | 10 | 19 |
2016 Mayo | 9 | 5 | 14 |
2016 Abril | 16 | 1 | 17 |
2016 Marzo | 10 | 8 | 18 |
2016 Febrero | 5 | 1 | 6 |
2016 Enero | 2 | 11 | 13 |
2015 Diciembre | 0 | 6 | 6 |
2015 Noviembre | 0 | 7 | 7 |
2015 Octubre | 0 | 6 | 6 |
2015 Septiembre | 0 | 3 | 3 |
2015 Agosto | 0 | 2 | 2 |
2015 Julio | 0 | 1 | 1 |