In Reply We thank you for your letter and interest in our report of a patient with a variant of the AESOP syndrome.1 The histologic features of the cutaneous manifestation of AESOP syndrome alone are nondiagnostic. Our patient’s cutaneous lesions and lymphadenopathy are consistent with the clinical features of AESOP syndrome, and they resolved with treatment of the underlying malignant neoplasm. As you have mentioned, the underlying neoplasm in this case was a Ewing sarcomalike malignant blue-cell tumor, which, unlike plasmacytoma, may result in production of different cytokines, leading to a variation in the histopathologic findings of the cutaneous lesion. While there are certain histologic features that may raise the question of a multinucleated-cell angiohistiocytoma, those lesions tend to manifest in acral locations and are not associated with an underlying malignant neoplasm, unlike that in our case, which had the clinical features consistent with a variant of the AESOP syndrome.
Foo CW, Florell SR, Petersen MJ. A Variant of AESOP Syndrome (Adenopathy and Extensive Skin Patch Overlying a Plasmacytoma)—Reply. JAMA Dermatol. 2013;149(9):1118. doi:10.1001/jamadermatol.2013.4776