Persistent Truncal Eruption With Hematologic Disease.

Abstract

We present a clinicopathological challenge involving a persistent truncal eruption in a patient with Waldenström macroglobulinemia. Clinical examination showed erythematous to violaceous macules and plaques, and biopsy demonstrated a dermal lymphoplasmacytic infiltrate with IgM/κ restriction. Molecular analysis identified MYD88 L265P in the cutaneous specimen. Integration of the clinical history, immunophenotype, clonality studies, and molecular findings supported secondary cutaneous lymphoplasmacytic lymphoma rather than cutaneous macroglobulinosis, primary cutaneous marginal zone lymphoma, or drug eruption.