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Multiple hyperkeratotic spicules and myeloma.

R P Braun1, A M Skaria, J-H Saurat

  • 1Department of Dermatology, University Hospital, Geneva, Switzerland. braun@cmu.inige.ch

Dermatology (Basel, Switzerland)
|September 10, 2002
PubMed
Summary

A rare skin condition, paraneoplastic hyperkeratotic spicules, appeared in a patient with IgG multiple myeloma. This case highlights a distinctive disorder linked to paraproteinemia.

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Area of Science:

  • Dermatology
  • Oncology
  • Immunology

Background:

  • Multiple myeloma is a plasma cell malignancy.
  • Monoclonal gammopathy of the IgG type is a common subtype of multiple myeloma.
  • Paraneoplastic syndromes are disorders that arise from substances produced by cancer cells.

Observation:

  • A 58-year-old patient with IgG multiple myeloma presented with a unique skin eruption.
  • The eruption featured multiple hyperkeratotic spicules on the face, nose, and scalp.
  • Histopathology showed follicular orthohyperkeratosis.

Findings:

  • Direct immunofluorescence microscopy was negative, ruling out autoimmune blistering diseases.
  • The clinical and pathological findings were characteristic of paraneoplastic hyperkeratotic spicules.
  • This rare condition is associated with an underlying paraprotein or malignancy.

Implications:

  • This case expands the spectrum of cutaneous manifestations associated with multiple myeloma.
  • It underscores the importance of considering paraneoplastic syndromes in patients with unexplained dermatological findings.
  • Early recognition may aid in the diagnosis and management of underlying plasma cell dyscrasias.

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