Circumorificial plasmacytosis - Oral Mucosal Lesion
Alerts and Notices
Synopsis
CP presents as one or more erythematous mucosal plaque(s) with a cobblestoned, velvety, nodular, or papillomatous appearance. While CP can be asymptomatic, oral pain, swelling, dysphagia, hoarseness, and stridor have been reported. Secondary erosions may occur.
The etiology of CP is unknown, although patients with CP may have a history of autoimmune disease and/or atopy. CP has been reported to occur in a wide age range, but it most commonly occurs in patients older than 50 years.
Codes
ICD10CM:D72.822 – Plasmacytosis
SNOMEDCT:
37465004 – Plasmacytosis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Oral Crohn disease – Presents with "knife cut"-like linear ulcerations, pseudopolyps, or swelling / induration of the lips or oral mucosa. May be associated with gastrointestinal complaints or a history of inflammatory bowel disease. Biopsy will show a granulomatous dermatitis.
- Oral histoplasmosis – Presents with erythema, ulceration, and/or fungating mass of the buccal mucosa, tongue, or palate. May be associated with a history of immunosuppression and/or HIV and generally occurs with disseminated histoplasmosis infection. Biopsy will show granulomatous inflammation with intracellular yeasts.
- Oral squamous cell carcinoma – Presents with a red or white plaque or ulcer on the floor of the mouth, lateral tongue, or oral mucosa and is often indurated. May be associated with a history of smoking or alcohol use. Biopsy will show atypical squamous cells.
- Granulomatosis with polyangiitis (GPA) – Presents with gingival hyperplasia or gingivitis, mucosal ulceration, osteonecrosis of the palate, or oro-antral fistula formation. May be associated with other systemic findings of vasculitis / GPA such as respiratory tract involvement. Biopsy will show vasculitis.
- Plasma cell gingivitis (PCG) – Erythematous, reactive lesions resulting from a hypersensitivity reaction to chewing qat, betel nuts, tobacco, or highly flavored gum or candy. PCG spans a period of a few weeks, opposed to the months-long time course of CP, and resolves with removal of the offending agent.
- Cutaneous or systemic plasmacytosis – Exceedingly rare and distinct from CP, occurring in those of Japanese ancestry. Typically presents with widespread cutaneous involvement and lymphadenopathy.
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:05/05/2021
Last Updated:05/05/2021
Last Updated:05/05/2021