It appears this has been a longstanding issue and it would be great if we could get a response from the devs on this.
Love plexamp, but currently I use itunes to manage my library and ratings (I DJ and itunes is part of my workflow)
Enabling the itunes plugin causes Itunes to create .tmp files because plex is locking itunes.xml. If i disable the itunes plugin in Plex media server settings, Itunes deletes these files automatically. if I enable it, these files stick around, and the problem quickly piles up as each copy is around 300mb, and a new file gets created every time a song plays in itunes, or every few minutes while itunes is open.