Cutaneous lymphoma — or something else?

Case and photo courtesy of Ted Rosen, MD

A 31-year-old woman presents for evaluation of an asymptomatic, firm plaque on the forehead. Lesions of similar size and consistency were present at the nape of the neck and on the chest. The patient was in overall good health. A biopsy performed to rule out cutaneous lymphoma revealed almost pure sheets of plasma cells in the dermis. What are your diagnostic suspicions and what would your next step be?

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