Intertriginous plasmacytosis with plasmoacanthoma: report of a typical case and review of the literature

Abstract

Clinical manifestations of benign (reactive) plasma cell proliferations of the skin and mucosa consist of a relatively rare and distinct group in dermatologic disorders. They have generally been named according to their localization. We report a typical case of mucocutaneous plasmacytosis located on intertriginous areas of the skin as well as mucosa with a perianal tumoral mass diagnosed as plasmoacanthoma. To our knowledge, this is the first detailed case report, at least in English literature.

Plasmoacanthoma of oral cavity and plasma cell cheilitis: two sides of same disorder “oral plasma cell mucositis” ?

“…Candida albicans has been implicated in some cases [4]. However, its association with low levels of serum and secretary IgA remains unsubstantiated [4]. Poor orodental hygiene and associated inflammation seems likely cause in our patients as we could not elicit history of any other preceding trauma/irritation, allergies, tobacco/gum chewing, or use of other dentifrices and causal relationship with smoking will be speculative in case-2.…”

“…Perianal, periumbilical, or inguinal areas and toe web involvement has been reported [4]. Plasma cell cheilitis is another idiopathic benign inflammatory condition of lips having similar dense plasma cell infiltrate histologically.…”

“…Similarly, plasmoacanthoma too has been reported following trauma from beak of a bird or insect bites [6]. Candida albicans has been implicated in some cases [4]. However, its association with low levels of serum and secretary IgA remains unsubstantiated [4].…”

“…This appears plausible in view of the reports of co-occurrence of plasma cell mucositis and plasmoacnathoma or intertriginous plasmacytosis of skin, plasma cell orificial mucosistis together with plasmoacanthoma of oral commissures and peri-anum [4,5]; plasmoacanthoma perhaps representing its papillomatous version. However, due to lack of significant number of cases there is paucity of literature on the subject.…”

“…Although White et al [3] tried to clarify some of the confusion by grouping together these similar disorders involving different body sites (vulva, buccal mucosa, tongue, palate, epiglottis, and larynx) under the nomenclature of "plasma cell mucositis", its exact clinical status remained under studied. Recent reports on co-occurrence of plasma cell mucositis and plasmoacnathoma or intertriginous plasmacytosis of skin, plasma cell orificial mucosistis together with plasmoacanthoma of oral commissures and peri-anum [4,5] has evoked considerable interest for pathogenesis of this rare entity. Cases of plasma cell infiltrate of gums, tongue, oral and labial mucosa have been described mostly under atypical gingivostomatitis, plasma cell gingivostomatitis, plasma cell gingivitis or plasmacytosis mucosae in dental literature but this unusual entity remains under reported in dermatology literature.…”