Monoclonal Cryoglobulinemia Clinically Mimicking Leukocytoclastic Vasculitis: A Case Report and Literature Review

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ABSTRACT: Monoclonal cryoglobulinemia commonly presents with cutaneous manifestations and develops almost exclusively in the setting of an underlying lymphoproliferative or hematologic disorder of B-cell lineage. Herein, we describe a case of a 48-year-old woman who presented with a recurrent and symmetric hemorrhagic papular eruption. Punch biopsy and direct immunofluorescence were consistent with monoclonal cryoglobulinemia. Systemic workup was notable for elevated kappa free light chains with a monoclonal immunoglobulin M kappa component on serum protein electrophoresis, and bone marrow biopsy was consistent with lymphoplasmacytic lymphoma.