Track

Case Reports

Abstract

Multiple myeloma and plasma cell leukemia can present with dense plasma cell infiltrates in the skin, as can cutaneous plasmacytosis and reactive infiltrates arising in the setting of infection. We review the case of a 63-year-old male with a history of hemophilia factor VIII and adult cystic acne presenting with bilateral violaceous papules near the temples and on the glabella present for over 5 years. Biopsy revealed a nodular plasmacytic infiltrate in the reticular dermis. Immunohistochemistry stains highlighted numerous CD138 positive plasma cells and few CD20 and PAX5 positive B-cells. Interspersed CD3-positive T lymphocytes were also noted. We review the clinical and histologic features needed to distinguish between the various plasmacytic infiltrates of the skin, the work up needed for an accurate diagnosis, and the current treatment options.