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Erythematous Papules on the Legs—Diagnosis
Arch Dermatol. 2009;145(1):77-82.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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Diagnosis: IgM storage papules in association with WM.
MICROSCOPIC, LABORATORY, AND RADIOLOGIC FINDINGS AND CLINICAL COURSE
Findings from microscopic examination demonstrated amorphous, eosinophilic material in the dermal papillae and reticular dermis, including around the blood vessels and appendages. The material was stained with periodic acid–Schiff. Laminin, type IV collagen, and CD34 expression were noted in the perivascular deposits, and anti-IgM labeled the amorphous substance. Electron microscopy revealed capillaries surrounded by electron-dense, finely granular material consistent with immunoglobulin deposits. Microscopic findings were consistent with IgM storage papules. His serum viscosity ratio was 2.1 (reference range, 1.4-1.8).
Abdominal ultrasonography revealed hepatosplenomegaly. The patient received the following therapies: chlorambucil, prednisone, 2 cycles of plasmapheresis, and 2 courses of rituximab. In several months, his serum IgM levels decreased from 6759 to 2999 mg/dL (reference range, 50-320 mg/dL) (to convert to milligrams per liter, multiply by 10), and his cutaneous lesions resolved.
DISCUSSION
Initially described in 1944, WM is a rare, chronic, B-cell disorder featuring a monoclonal proliferation of lymphoplasmacytes in the . . . [Full Text of this Article]
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Arch Dermatol. 2009;145(1):77-82.
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