The pathophysiology or mechanism of Reinkes edema is not well known, however, chemicals contained within cigarette smoke are associated with an increased vascular permeability of blood vessels, which results in fluid leaking into the Reinkes space. Normally, the vocal cords are surrounded by neatly aligned blood vessels, however, these blood vessels can become disarranged and fragile in Reinkes edema. In addition, cigarette smoke can create reactive oxygen species that alter the environment of the vocal cords. Tissue analysis of Reinkes edema shows decreased amounts of the proteins fibronectin, elastin, collagens I and III, and extracellular matrix proteins. This leads to an overall decreased stiffness of the tissue layer, which vibrates more slowly and produces a deeper sounding voice.The progression of Reinkes edema is gradual and is directly related to the duration of exposure to risk factors, such as smoking and gastric reflux. Disease progression is divided into two types: "pale" and "livid". The “pale” type of Reinkes edema is defined by a glazed appearance of the vocal cords with a clear (colorless) fluid underneath. This represents the early stage of the disease. The advanced “livid” type of Reinkes edema is identified by an increased amount of fluid, accompanied by a color change from colorless to yellow-grey. The swelling of the vocal folds cause ballooned-like appearance, known as a polyp. The polyps of Reinkes edema are usually benign, however, there may be a risk of cancer if the patient is a smoker.
Plasmacytosis is a condition in which there is an unusually large proportion of plasma cells in tissues, exudates, or blood. : 743   Plasmacytosis may be divided into two types—cutaneous and systemic—both of which have identical skin findings. : 743 
Patients with plasmacytosis have been predominantly found to have lung infections (pneumonia, tuberculosis, abscess) whereas multiple myeloma is rarely found. See also
Cutaneous B-cell lymphoma
Multiple myeloma
Plasmacytoma
Skin lesion

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