Plane xanthomatosis associated with myelomatosis

Immunohistochemical Study of Human Xanthoma

“…Various forms of human xanthoma are known to correspond to types of hyperlipoproteinemia (1, [28][29][30]. Plane xanthoma is found in patients with various types of primary hyperlipoproteinemia (1, 28-31), obstructive jaundice (29,30,32), multiple myeloma (31,33), dysglobulinemia (23,34), leukemia (35), and even in normolipemics without pathologic findings (36,37). The reasons for the varieties of xanthomas are uncertain.…”

Papular Xanthoma

“…Histiocytic syndrome like generalized erup tive histiocytoma [9] show xanthomization only as a secondary phenomenon. Among normolipemic xanthomatosis the diffuse normolipemic xanthom a planum [10] starts from the eyelids as a xanthelasma and then spreads to other parts of the body: lesions are macular or only slightly infiltrated and the condition [11] is often associated with multiple myeloma. Normolipemic eruptive cutaneous xanthomatosis [12] is character ized by small erythematous papules confluenting into large plaques.…”

Cutaneous manifestations of paraproteinaemia. Part II

“…Similar mechanisms may operate in cases of PG-associated arthritis. Soluble immune-complexes, particularly IgA containing complexes, are known to inhibit polymorph chemotaxis (Leung-Tack, Maillard & Voisin, 1979;Todd Davies et al, 1977;Ito et al, 1979), neutrophil chemotaxis is defective in patients with rheumatoid arthritis (Mowlat & Baum^ 1971), and reduced chemetaxis in vitro or defective pol5miorph migration in vivo has been documented in cases of PG-associated arthritis (Holt et al, 1980). It would, however, be difficult to account for all cases of pyoderma gangrenosum on this basis.…”

“…Such observations indicate that the formation of circulating complexes is only one mechanism by which paraproteins with antilipoprotein activity interfere with lipid metabolism, and that hyperlipidaemia is not a prerequisite for the development of skin lesions in DPX. This explains why the lipid composition of xanthomata in DPX does not correspond with the serum lipids (Kodama, Nakagawa & Tanioku, 1972), and also accounts for the observation that these xanthcmata may respond to therapy for the myeloma, but not for the hyperlipidaemia (Moschella, 1970). A variety of techniques have been used to identify and analyse lipoprotein-paraprotein complexes.…”