Differential Diagnosis |
Tests/histology specific to each disease |
Differential Diagnosis |
Tests/histology specific to each disease |
Mucous membrane plasmacytosis |
+ histologic dense subepithelial plasma cell infiltrate + histologic psoriasiform changes and acanthosis +/- erosions of epithelium |
Cheilitis granulomatosa |
+ histologic glaucomatous infiltrate No histologic plasma cell infiltrate No histologic psoriaform changes |
Fungal Infection |
Neg. fungal hyphae Neg. fungal culture No response to nystatin |
Plasma cell granuloma |
+ histologic granulomatous infiltrate No histologic plasma cell infiltrate No histologic psoriaform changes |
Sarcoidosis |
+ granuloma composed of epithelioid histiocytes, giant cell, Asteroid bodies No histologic plasma cell infiltrate No psoriaform changes |
Melkerson-Rosenthal syndrome |
+ histologic tuberculoid type granuloma with lymphedema + histologic banal perivascular infiltrate No histologic psoriasiform changes |
Syphilis |
Neg. STS No syphilis infection by silver stain No signs/symptoms of syphilis + histologic band-like perivascular infiltrate of plasma cells, lymphocytes and macrophages + psoriasiform epidermal hyperplasia and hyperkeratosis |
Rhinoscleroma |
+ histologic granuloma composed primarily of plasma cells + occasional Mikulicz's cells and Russell bodies + Warthin-starry silver stain of bacilli + culture for Klebsiella rhinoscleromatis + serologic tests for Klebsiella rhinoscleromatis |
Lichen Planus |
+ histologic superficial band of lymphocytic infiltrate + Occasional histologic hyperkeratosis No histologic plasma cell infiltrate |
Plasmoacanthoma |
+ discrete verrucose tumor + histologic plasma cell infiltrate + histologic plasma cell infiltrate |
Cicatricial Pemphigoid |
+ vesicles, erosions and ulcers of mucosa + histologic subepithelial disruption and/or ulceration No histologic psoriaform changes No histologic dense plasma cell infiltrate |
Melkerson-Rosenthal syndrome |
+ histologic tuberculoid type granuloma with lymphedema + histologic banal perivascular infiltrate No histologic psoriasiform changes |
Allergic or contact mucositis |
Inconclusive history Inconsistent distribution of lesions Neg. patch testing + histologic infiltration of monocytes and histiocytes in dermis (allergic contact dermatitis) + histologic superficial vesicles with PMNs (contact dermatitis) No improvement with removal of foreign objects/dentures |
Rosai-Dorfman disease |
+ histologic perivascular infiltrate of lymphocytes and plasma cells + histologic diffuse infiltration of large, foamy histiocytes in the dermis + histologic fibrosis and lymphophagocytosis No histologic psoriasiform changes |
Plasmoacanthoma |
+ discrete verrucose tumor + histologic plasma cell infiltrate + histologic plasma cell infiltrate |
Primary cutaneous plasmacytoma |
+ histologic diffuse infiltrate of plasma cells +/- histologic atypia of plasma cells + monoclonal antibody production on immunohistochemistry or gene rearrangement studies |
Carcinoma |
No histologic evidence of squamous cell carcinoma |
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