Requena L, Sarasa J L, Ortiz Masllorens F, Martín L, Piqué E, Olivares M, Fariña M C, Prieto E, Pacho E, Gómez Octavio J
Department of Dermatology, Fundación Jiménez Díaz, Clínica de Nuestra Señora de la Concepción, Universidad Autónoma, Madrid, Spain.
J Am Acad Dermatol. 1995 May;32(5 Pt 2):834-9. doi: 10.1016/0190-9622(95)91542-7.
We describe a patient with multiple myeloma and cryoglobulinemia who had spicules with a horny appearance in the follicular openings of the face, particularly on the nose. Histopathologic study demonstrated that these spicules consisted of eosinophilic homogeneous deposits in the intercellular spaces between keratinocytes in the upper layers of the follicular infundibulum. Direct immunofluorescence, ultrastructural, and biochemical investigations revealed that these eosinophilic deposits were cryoprecipitates composed of IgG-kappa with electrophoretic characteristics identical to those of the paraprotein present in the serum of the patient. Hence we believe that these lesions are best referred to as pseudohyperkeratotic spicules of the nose, and that they are a characteristic cutaneous manifestation of patients with multiple myeloma and cryoglobulinemia.
我们描述了一名患有多发性骨髓瘤和冷球蛋白血症的患者，其面部毛囊开口处，尤其是鼻子上有角质样的细刺。组织病理学研究表明，这些细刺由毛囊漏斗上层角质形成细胞之间细胞间隙中的嗜酸性均质沉积物组成。直接免疫荧光、超微结构和生化研究显示，这些嗜酸性沉积物是冷沉淀，由IgG-κ组成，其电泳特征与患者血清中存在的副蛋白相同。因此，我们认为这些病变最好称为鼻部假性角化过度性细刺，并且它们是多发性骨髓瘤和冷球蛋白血症患者的特征性皮肤表现。
