LAUSR

sis of POEMS syndrome-associated multicentric Castleman disease was not supported by the absence of peripheral neuropathy in our case. Prior to anakinra treatment, we treated the patient with tocilizumab, which only partially improved urticarial rash on the localized erythematous patches. On the other hand, the administration of anakinra demonstrated prompt favourable responses to clinical manifestations. Taken together, although the possibility of Castleman disease and cutaneous plasmacytosis cannot be completely excluded, our case is considered as Schnitzler syndrome. We agree with the insightful notion by Dr Wang that skinassociated lymphoid tissue (SALT) can be formed under the influence of hypercytokinaemia as a sign of systemic disease. Therefore, we termed these lymphoid follicles as inducible SALT (iSALT). It is yet to be elucidated whether iSALT formation is a characteristic of Schnitzler syndrome or a unique phenomenon detected in our patient, who manifested wheals on recurrent localized erythema, which is not commonly observed in Schnitzler syndrome. We believe that further investigation is required to clarify the pathogenesis and the function of iSALT in various skin diseases. Acknowledgments: We thank Dr Prof. H. Kawabata of Kanazawa Medical University for his informative guidance about the diagnosis of Castleman disease.