Primary cutaneous plasmacytosis: report of three cases and review of the literature.

BACKGROUND: Cutaneous plasmacytosis is a rare disease characterized by peculiar multiple eruptions and hypergammaglobulinemia. More than 40 cases have been reported, mainly in Japan, although information concerning the disorder was limited to individual case reports. OBJECTIVE AND METHODS: To clarify the clinicopathological and laboratory features, we reviewed 41 cases. RESULTS: All patients were Japanese and the male-to-female ratio was 1:0.6. The onset ages ranged from 20 to 62 years, with a mean and median of 37 and 37 years. A superficial lymphadenopathy was detected in 58% (22/38), and polyclonal hypergammaglobulinemia was found in 93% (38/41). No cases were associated with any apparent underlying diseases. The course was chronic without spontaneous remission. Four patients died, 3 of whom succumbed to leukemia, respiratory failure or renal failure, respectively. CONCLUSION: The results suggest that the condition appears to be a variant of reactive plasmacytic disorders of unknown origin.

[A taxonomic study on a mycobacterium which caused a skin ulcer in a Japanese girl and resembled Mycobacterium ulcerans].

A taxonomic study has been made on a mycobacterial strain isolated from skin ulcer lesion of a 19 year-old Japanese girl who has lived only in Japan. By numerical classification, in which 108 characters were used, 6 isolates of this strain formed one cluster together with Mycobacterium ulcerans strains. However, the isolates were distinguished from the M. ulcerans strains, forming a subcluster. The isolates were differentiated by the characters shown in Table 2 from authentic M. ulcerans strains. The mycolic acids of the strain ATCC 33788 isolated from Japanese girl were distinguished from those of the type strain ATCC 19423 of M. ulcerans. The number of carbon atoms of alpha-mycolate of the former centered at 80, whereas those of the strain ATCC 19423 at 76. The number of carbon atoms of the alpha-unit was 24 in both strains and the number of double bonds was 2 in both strains. The strain ATCC 33788 showed a 100% similarity with the strain ATCC 19423 in DNA hybridization. In view of the above results, we have concluded that the strain belongs to a new subspecies of M. ulcerans (M. ulcerans subsp. shinshuense). Until now, M. ulcerans infection has occurred only in three area of the world, Africa, Oceania, and South and Middle America. Our case is the first case of M. ulcerans infection discovered in an area other than the above. However, the strain was not the same as the M. ulcerans described previously but differed from it in mycolic acids and some biological and biochemical characteristics.

Phytohemagglutinin-binding sites in the skin. A useful histochemical marker of acrosyringium and distal portions of intradermal sweat ducts.

Phytohemagglutinin (PHA)-binding sites were histochemically investigated in normal adult skin and various skin tumors using peroxidase-labeled lectin. In the normal skin, acrosyringium and distal portion of intradermal duct of eccrine and apocrine sweat glands were intensely stained with PHA. Other elements of the skin were virtually negative. Among various kinds of sweat gland tumors and other skin tumors, syringoma and eccrine porocarcinoma were intensely stained with PHA. Small ductal structures of nodular hidradenoma and mixed tumor of the skin were also stained with PHA. No other skin tumors were positive with PHA staining. The present study clearly showed that PHA is a useful histochemical marker of distal portion of eccrine and apocrine sweat ducts.