Recurrent chancriform mucous membrane ulcer in plasmacytoma with secondary IgA deficiency. Pyoderma chancriforme of the tongue

• Published in: Hautarzt Vol. 52; no. 9; pp. 820 - 823
• Main Authors: Hegemann, B, Helmbold, P, Dickert, C, Marsch, W C
• Format: Journal Article
• Language: German
• Published: Germany 01-09-2001
• Subjects: Aged; Chancroid - diagnosis; Chancroid - pathology; Diagnosis, Differential; Epithelium - pathology; Glossitis - diagnosis; Glossitis - pathology; Humans; IgA Deficiency - diagnosis; IgA Deficiency - pathology; Male; Multiple Myeloma - diagnosis; Multiple Myeloma - pathology; Oral Ulcer - diagnosis; Oral Ulcer - pathology; Paraneoplastic Syndromes - diagnosis; Paraneoplastic Syndromes - pathology; Tongue - pathology
• ISSN: 0017-8470

A 66 year old patient presented with a nine month history of recurrent oral ulcerations involving the tongue. We diagnosed chancriform pyoderma and a previously not identified multiple myeloma with secondary immunoglobulin deficiency. Clinically and histologically we excluded a necrotizing ulcerative stomatitis as found in individuals with cellular immunodeficiency as in late-stage HIV-infection. On culture only Neisseria catarrhalis was found. Chancriform pyoderma is often associated with local bacterial infections, especially Staphylococcus aureus. The most common sites are the genitalia and periorbital region; involvement of the oral mucosa is uncommon. To the best of our knowledge, this is the fourth reported case with tongue lesions. The multiple myeloma-associated immunoglobulin deficiency might have facilitated the oral manifestations of chancriform pyoderma.