Cutaneous follicular hyperkeratotic spicules – the first clinical sign of multiple myeloma progression or relapse

Tay, Leslie; Lim, Francesca; Ng, Heng Joo; Lee, Haur Yueh; Pang, Shiu-Ming; Thirumoorthy, T

doi:10.1111/j.1365-4632.2009.04369.x

Cited by 20 publications

(18 citation statements)

References 17 publications

(26 reference statements)

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“…Other common associations reported include chronic renal failure, Crohn's disease, hypovitaminosis A, HIV infection, lymphoma, and other malignancies. [1112] No any such association was found in our case. Among the drugs, cyclosporine and sorafenib are reported to cause similar eruption.…”

Section: Discussionsupporting

confidence: 43%

“…[51011] SFH, although uncommon, is a characteristic paraneoplastic cutaneous manifestation of MM found mostly in white male patients. Other common associations reported include chronic renal failure, Crohn's disease, hypovitaminosis A, HIV infection, lymphoma, and other malignancies.…”

Section: Discussionmentioning

confidence: 99%

“…first showed that these follicular spicules contained myeloma dysprotein and cryoglobulins precipitating into the follicular infundibulum and stated that spicules were a clinical manifestation of cryoglobulinemia because they were localized to cold-exposed areas. [1011]…”

Section: Discussionmentioning

confidence: 99%

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Adult onset atopic dermatitis with secondary follicular mucinosis with cyclosporine induced spiny follicular hyperkeratosis and hair casts

Gutte

2013

Indian J Dermatol

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Secondary follicular mucinosis developing in adult patient with atopic dermatitis (AD) was observed on histology. Due to severity of disease, patient was started on oral cyclosporine 300 mg daily in 3 divided doses. Two weeks later patient started developing multiple spiny follicular keratoses mainly on face but also on extremities and trunk along with hair casts on scalp. Repeat biopsy from such keratotic lesions confirmed diagnosis spiny follicular hyperkeratosis (SFH). On investigations no evidence of multiple myeloma or any other malignancy was found. Cyclosporine was stopped and lesions cleared over 2 weeks. We report this case due to rare association of AD with follicular mucinosis and cyclosporine induced SFH with hair casts.

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Section: Discussionsupporting

confidence: 43%

Section: Discussionmentioning

confidence: 99%

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Adult onset atopic dermatitis with secondary follicular mucinosis with cyclosporine induced spiny follicular hyperkeratosis and hair casts

Gutte

2013

Indian J Dermatol

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“…This includes possible application of trichoscopy in identifying follicular spicules in multiple myeloma, 38 follicular mucinosis in lymphoproliferative disorders, 39 …”

Section: Trichoscopy In General Medicinementioning

confidence: 99%

Trichoscopy update 2011

Rudnicka¹,

Olszewska²,

Rakowska³

et al. 2011

J Dermatol Case Rep

230

259

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Trichoscopy performed with a handheld dermoscope or a videodermoscope became an indispensable tool in differential diagnosis of hair and scalp diseases. Current research is focusing on trichoscopy of: 1) non-cicatricial alopecia, 2) cicatricial alopecia, 3) hair shaft disorders, and 4) inflammatory scalp diseases. This review summarizes current knowledge in these four fields of research. In all non-cicatricial alopecias presence of empty follicular openings is a common trichoscopy finding. In alopecia areata black dots and micro-exclamation mark hairs and tapered hairs correlate with disease activity, whereas yellow dots and vellus hairs correlate with disease severity. In androgenic alopecia trichoscopy shows hair shaft thickness heterogeneity, multiple thin and vellus hairs, yellow dots, perifollicular discoloration, and predominance of follicular units with only one hair. These features predominate in the frontal area. In all forms of cicatricial alopecia, trichoscopy shows milky-red or ivory-white areas lacking follicular openings. In classic lichen planopilaris trichoscopy shows perifollicular inflammation, tubular perifollicular scaling, elongated, concentric blood vessels and "classic white dots", which merge to form white areas. Frontal fibrosing alopecia shows mild perifollicular scaling. Folliculitis decalvans is characterized by tufted hairs, large follicular pustules with emerging hair shafts and perifollicular starburst pattern hyperplasia. In dissecting cellulitis characteristic findings are "3D" yellow dots imposed over dystrophic hairs, large, yellow amorphous areas and pinpoint white dots with a whitish halo. Trichoscopy is particularly useful to diagnose hair shaft abnormalities in trichorrhexis nodosa, trichorrhexis invaginata, monilethrix, pili torti, and pili annulati. The method may be also useful in diagnosing inflammatory scalp diseases. In discoid lupus erythematosus trichoscopy shows large arborizing vessels and large hyperkeratotic folliculilar yellow dots. Trichoscopy of scalp psoriasis shows regularly distributed twisted and lacelike blood vessels, whereas in seborroic dermatitis thin arborizing vessels may be observed. In tinea capitis trichoscopy shows comma, corkscrew and zigzag hairs. Examination tinea capitis may be facilitated by UV-light enhanced trichoscopy (UVET). In conclusion, trichoscopy is a non-invasive method which may be applied in differential diagnosis of most hair and scalp diseases.

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“…L'aspect clinique est celui d'une kératose folliculaire. Sur le plan histologique, on peut observer des dépôts éosino-philes homogènes d'immunoglobuline monoclonale dans les espaces interkératinocytaires des couches superficielles de l'infundibulum folliculaire [27][28][29][30].…”

Section: Spicules Folliculaires (« Follicular Spicules ») Du Nezunclassified

Manifestations dermatologiques des gammapathies monoclonales : apport de l’histopathologie cutanée

Lacoste¹,

Ingen‐Housz‐Oro

Ortonne³

2015

Annales de Pathologie

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Cutaneous follicular hyperkeratotic spicules – the first clinical sign of multiple myeloma progression or relapse

Cited by 20 publications

References 17 publications

Adult onset atopic dermatitis with secondary follicular mucinosis with cyclosporine induced spiny follicular hyperkeratosis and hair casts

Adult onset atopic dermatitis with secondary follicular mucinosis with cyclosporine induced spiny follicular hyperkeratosis and hair casts

Trichoscopy update 2011

Manifestations dermatologiques des gammapathies monoclonales : apport de l’histopathologie cutanée

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