Letters to the Editor 740 JEADV 2006, 20, 735–767 © 2006 European Academy of Dermatology and Venereology pemphigoid antibodies, pathergy test (Behçet disease), as well as fungal and bacterial cultures of the oral mucosa. Thus, oral and genital plasma cell mucositis was diagnosed. Internal treatment with an initial dose of prednisolone 70 mg per os daily led to complete remission; however, after stepwise reduction to 7.5 mg prednisolone new aphthous lesions reappeared. Treatment with 150 mg dapsone was not effective. Finally, local treatment with cyclosporin solution was initiated: cyclosporin solution (Sandimmun-Optoral®) and olive oil were mixed 1 : 1 and 5 mL were applied to a swab. Cyclosporin solution soaked swabs were pressed onto the lesions twice daily for a time of 15 min. After improvement within the first week of treatment, the dose was stepwise reduced to every second day application. During 6 months of follow- up nearly complete remission was kept under medication with topical cyclosporin three times weekly and pred- nisolone 5 mg/day. It remains somewhat speculative how far the esophagitis of our patient might be due to the involvement of the upper digestive tract which has been described in the literature. 4 In oral plasma cell mucositis parodontitis, mechanical trauma, actinic damage or contact sensitization have been suspected to contribute to its development. 5 Our patient reported a complete dental replacement due to parodontosis 3 years prior to the onset of the stomatitis. Successful use of topical ciclosporin has been reported for treatment of oral lichen planus, 6 morbus Behçet, 7 oral pemphigus 8 and persistent aphthous stomatitis. 9 To our knowledge, this is the first report of its successful use in oral plasma cell mucositis. C Heinemann,* T Fischer, U Barta, A Michaelides, P Elsner Department of Dermatology and Dermatological Allergology, University-Hospitals of the Friedrich Schiller University Jena, Erfurterstr. 35, 07740 Jena, Germany, *Corresponding author, Dermato Esthetic Laser Centrum, Rue de Marché, 2502 Bienne, Switzerland, tel. +41 323225355/+49 3641 937329; fax +49 3641 937410 E-mail: christian.heinemann@derma.uni-jena.de References 1 Zoon J. Balanoposthite chronique circonscrite benigne a plasmocytes (contra erythroplasie de Queyrat). Dermatologica 1952; 105: 1–7. 2 Baughman RD, Berger P, Pringle WM. Plasma cell cheilitis. Arch Dermatol 1974; 110: 725 –726. 3 White JW Jr, Olsen KD, Banks PM. Plasma cell orificial mucositis. Report of a case and review of the literature. Arch Dermatol 1986; 122: 1321–1324. 4 Smith ME, Crighton AJ, Chisholm DM et al. Plasma cell mucositis: a review and case report. J Oral Pathol Med 1999; 28: 183 –186. 5 Kaur C, Thami GP, Sarkar R et al. Plasma cell mucositis. J Eur Acad Dermatol Venereol 2001; 15: 566 –567. 6 Eisen D, Ellis CN, Duell EA et al. Effect of topical cyclosporine rinse on oral lichen planus. A double-blind analysis. N Engl J Med 1990; 323: 290–294. 7 Sakane T, Takeno M. Current therapy in Behcet’s disease. Skin Ther Lett 2000; 5: 3–5. 8 Gooptu C, Staughton RC. Use of topical cyclosporin in oral pemphigus. J Am Acad Dermatol 1998; 38: 860–861. 9 Eisen D, Ellis CN. Topical cyclosporine for oral mucosal disorders. J Am Acad Dermatol 1990; 23: 1259 –1263; discussion 1263 –1264. 10 Timms MS, Sloan P. Association of supraglottic and gingival idiopathic plasmacytosis. Oral Surg Oral Med Oral Pathol 1991; 71: 451– 453. DOI: 10.1111/j.1468-3083.2006.01467.x ? 2006 18 ? Letter to the Editor Letter to the Editor Letter to the Editor LETTERS TO THE EDITOR A pigmented acral lesion Editor Traumatic haemorrhages, as response to persistent local trauma or irritation, especially located on the soles, can be sometimes mistaken clinically for a melanocytic lesion. In fact, clinical differentiation of early melanoma from a benign lesion is sometimes difficult, because both present as a brownish-black macula. A 60-year-old white woman presented herself with a pigmented lesion on her third left toe with a duration of 1 year. She stated that the lesion was asymptomatic since fig. 2 Histological slide of a biopsy from the lip mucosa before treatment (haematoxylin–eosin stain, magnification ×40) shows pseudoepithelioma- tous hyperplasia of the epidermis 10 and a dense plasmacytic infiltrate with- out cell atypia in the upper dermis.