Rare types of vasculitis as markers of plasmocytoma

• Published in: Hautarzt 2006-02, Vol.57 (2), p.137-143
• Main Authors: Marini, A, Fenk, R, Plettenberg, H, Ruzicka, T, Haas, R, Hengge, U R
• Format: Article
• Language: ger
• Subjects: Aged; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Plasmacytoma - complications; Plasmacytoma - diagnosis; Rare Diseases - diagnosis; Rare Diseases - etiology; Skin Neoplasms - complications; Skin Neoplasms - diagnosis; Vasculitis - diagnosis; Vasculitis - etiology
• ISSN: 0017-8470
• DOI: 10.1007/s00105-004-0890-5

We report on two female patients who presented with painful recurrent palpable purpura, ulcers and necroses on the extremities. The results of all examinations and laboratory tests considered together suggested a diagnosis of necrotizing leukocytoclastic vasculitis. Leukocytoclastic vasculitis is an inflammatory necrotizing condition of the superficial dermal vessels, presenting with variable clinical symptoms. In most cases it becomes manifest as palpable purpura, but hemorrhagic-necrotizing, bullous, nodular and urticarial presentations also occur. Common etiological factors include bacterial, viral or drug antigens, chronic infections (hepatitis B and C), non-Hodgkin lymphomas (monoclonal gammopathy, multiple myeloma), leukemia (hairy cell leukemia), and tumors (bronchial, breast, and gastric cancer) and also connective tissue disorders. In the course of the work-up, a plasmocytoma was discovered as the cause of the leukocytoclastic vasculitis, presenting in a similar way to livedo reticularis in one case and to pyoderma gangraenosum in the other.