Hair Casts and Cutaneous Spicules in Multiple Myeloma

Multiple minute digitate hyperkeratosis: A proposed algorithm for the digitate keratoses

“…Treatments have not been reported in the literature. We favor the term ''postirradiation digitate keratosis'' over the synonymous terms presented in Table I, as this was the term first used when described by Burns 35 in 1986. Hyperkeratotic spicules [39][40][41][42][43][44][45][46][47] are follicular or nonfollicular digitate keratoses of the face (nose in particular), and may also involve the scalp, trunk, and limbs. They are often associated with paraproteinemia, multiple myeloma, and cryoglobulinemia, but may be idiopathic.…”

“…It is distinct from 46 Trichodysplasia of immunosuppression 48 Viral-associated trichodysplasia spinulosa Pilomatrix dysplasia Cyclosporine-induced folliculodystrophy Spiny keratoderma 26,29,31,32 Punctate porokeratotic keratoderma 22,23,25,28 Music box spine dermatosis Multiple minute palmar-plantar digitate hyperkeratosis 24 Filiform hyperkeratosis 27,30 MMDH, Multiple minute digitate hyperkeratosis.…”

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

“…[7] In our case lesions cleared completely on stopping cyclosporine without any additional topical therapy.…”

“…Majority of cases reported are associated with MM however,[7] in our case no any underlying malignancy was detected.…”

Skin spicules: A newly described paraneoplastic phenomenon associated with a marginal zone B-cell lymphoma

“…Since then, other cases have shown that the underlying monoclonal dysprotein in patients with monoclonal gammopathies, independent of cryoglobulinemia, may be responsible for the depositional cutaneous lesions. [14][15][16] We believe that the skin spicules in our patient represent a variant of the sign of Leser-Trélat, the eruptive appearance of multiple seborrheic keratoses. The sign of Leser-Trélat has been reported with multiple internal malignancies, with the most frequent associations being adenocarcinoma of the stomach, colon, and breast, but also occurring with lymphoma, leukemia, and melanoma.…”