Interstitial Granulomatous Dermatitis as the Initial Manifestation of Myeloma

Abstract

Trichosporon mycotoxinivorans was commonly used in various textile, agriculture, cosmetic, and pharmaceutical industries for its ability to detoxify mycotoxins such as ochratoxin A and zearalenone. In recent years, it has been isolated as a respiratory pathogen causing pneumonia in some cases of cystic fibrosis, but to our knowledge, a cutaneous manifestation has not been previously described. 6 We could not establish a route of exposure in our patient. Azoles have proven to be the most effective treatment options for other Trichosporon infections. 1-5 Our patient showed significant improvement of skin lesions with voriconazole.

Interstitial Granulomatous Dermatitis in a Patient with Prostate Cancer

“…Histopathological findings of IGD is characterized by interstitial arrangement of CD 68+ epithelioid histiocytes scattered throughout the dermis in varying densities, frequently around the foci of degenerated collagen23456. Rarely, eosinophils and neutrophils can be found in IGD.…”

“…Diseases reported in association with IGD include inflammatory arthritis, particularly rheumatoid arthritis, and connective tissue disease such as systemic lupus erythematosus, and hematologic disorders such as lymphoma and myelodysplastic syndrome23456. Other IGD associated diseases reported in the literature include autoimmune thyroiditis and autoimmune hepatitis, Churg-Strauss syndrome, Behcet's disease, pulmonary paracoccoidioidomycosis, pulmonary silicosis, antiphospholipid antibody syndrome, and Borrelia burgdorferi infection24.…”

“…Its prognosis is favorable with two-thirds of patients experiencing spontaneous remission after 3 months to 3 years23456.…”

“…Histological feature of IGD is interstitial infiltrate of histiocytes in the reticular dermis. IGD is associated with various systemic conditions, such as arthritis, autoimmune disease, connective tissue disease, and internal malignancy23456. We describe a rare case of IGD associated with prostate cancer.…”

Multiple Disseminated Pink Papules in Patient with Myelodysplastic Syndrome: A Quiz

“…The exact pathogenesis of IGD is unknown, but it is frequently associated with autoimmune diseases such as rheumatoid arthritis, Sjögren's syndrome and systemic lupus erythematosus. IGD is also described in association with drug reactions, solid-organ cancers, such as breast cancer, hypopharyngeal squamous cell carcinoma and lung cancer, and haematological malignancies, such as myeloproliferative disorders and MDS (3)(4)(5)(6).…”