IgA multiple myeloma presenting as an acquired bullous disorder
| Autor: | Karen Stapleton, Michelle J Hunt, Deanna A Wong |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Epidermolysis bullosa acquisita
Male medicine.medical_specialty Pathology Biopsy Dermatology Diagnosis Differential Fatal Outcome Dermis immune system diseases hemic and lymphatic diseases Dermatitis herpetiformis Immunopathology Antineoplastic Combined Chemotherapy Protocols Medicine Humans Fluorescent Antibody Technique Indirect Multiple myeloma Skin Lupus erythematosus integumentary system medicine.diagnostic_test Skin Diseases Vesiculobullous business.industry Middle Aged medicine.disease Rash Immunoglobulin A medicine.anatomical_structure Skin biopsy Disease Progression medicine.symptom business Multiple Myeloma |
| Zdroj: | The Australasian journal of dermatology. 40(1) |
| ISSN: | 0004-8380 |
| Popis: | A 63-year-old man presented with an intensely pruritic vesiculo-bullous eruption on the limbs and was subsequently found to have an IgA kappa multiple myeloma. The eruption clinically and histologically was suggestive of linear IgA disease (LAD), dermatitis herpetiformis (DH), epidermolysis bullosa acquisita (EBA), or bullous lupus erythematosus (LE), with the skin biopsy revealing subepidermal bullae and dermal papillary micro-abscesses. However, direct immunofluorescence showed a unique pattern of diffuse dermal IgA staining. Although chemotherapy produced a dramatic resolution of the lesions, which paralleled the fall in serum IgA paraprotein level, the myeloma later became progressive and the resulting paraprotein increase was accompanied by recurrence of the eruption. We propose that this patient's rash was the presenting manifestation of his multiple myeloma, and was a consequence of transudation of IgA paraprotein into the dermis. |
| Databáze: | OpenAIRE |
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