Linked article: This article is commentary on by L. Fania et al., pp. e439–e440 in this issue. To view this article visit https://doi.org/10.1111/jdv.14965

Despite the increased awareness, antimalarials-triggered psoriasis is still diagnosed. Fortunately, the current artemisinin-based antimalarial treatment can be safely offered to susceptible individuals. Additionally, prophylaxis with doxycycline or the combination atovaquone-proguanil could be a safe suggestion for malaria prophylaxis in psoriatic patients.

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With this review we firstly describe uncommon manifestations of paraprotein-associated hematological diseases in 2 patients presenting with hemoptysis. The differential diagnosis in both cases included qualitative and quantitative platelet abnormalities, infectious diseases, malignancies, vasculitis, collagen diseases and blood disorders. Among other interventions undertaken, bone marrow biopsy provided evidence of a primary hematological disease while serum protein electrophoresis and immunofixation indicated the presence of a paraprotein. As a “take-away” lesson from the literature review performed on the basis of these cases the bleeding diathesis that is occasionally associated with paraproteinemia should be pointed out, irrespectively of the primary hematological condition. Thus, while investigating a patient with bleeding diathesis, at least a serum protein electrophoresis should be among the requested laboratory tests. Moreover, clinical vigilance is required in order to recognize other unusual manifestations of not so unusual hematological abnormalities.