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Acquired bullous dermatosis associated with IgA multiple myeloma: a case report.
J Cutan Pathol. 2010 Nov; 37(11):1174-7.JC

Abstract

We present the case of a patient with IgA paraprotein who developed hemorrhagic subepidermal vesicles and bullae with numerous neutrophils. Direct immunofluorescence test (DIF) showed weak deposits of IgA lambda paraprotein at the dermal-epidermal junction and at the intercellular level in the basal layer of the epidermis, and stronger deposits in a perivascular and diffuse pattern in the dermis. Indirect immunofluorescence (IIF) test revealed the presence of circulating IgA lambda antibodies reacting with the intercellular space of monkey and guinea pig esophagus and human skin. A blood test revealed an IgA lambda paraprotein and multiple myeloma stage I(0) was diagnosed in a later hematological study. Dapsone was prescribed and cutaneous lesions improved. This is the second report of subepidermal vesicles and bullae with dermal deposits of IgA paraprotein appearing prior to diagnosis of an IgA multiple myeloma, and it is a unique case with circulating IgA lambda antibodies reacting with the intercellular space of epithelia.

Authors+Show Affiliations

Department of Dermatology, Hospital Sta Creu i St Pau, Barcelona, Spain. MBarnadas@hsp.santpau.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19638068

Citation

Barnadas, Maria A., et al. "Acquired Bullous Dermatosis Associated With IgA Multiple Myeloma: a Case Report." Journal of Cutaneous Pathology, vol. 37, no. 11, 2010, pp. 1174-7.
Barnadas MA, Gelpí C, Martínez L, et al. Acquired bullous dermatosis associated with IgA multiple myeloma: a case report. J Cutan Pathol. 2010;37(11):1174-7.
Barnadas, M. A., Gelpí, C., Martínez, L., Curell, R., Martino, R., & Alomar, A. (2010). Acquired bullous dermatosis associated with IgA multiple myeloma: a case report. Journal of Cutaneous Pathology, 37(11), 1174-7. https://doi.org/10.1111/j.1600-0560.2009.01383.x
Barnadas MA, et al. Acquired Bullous Dermatosis Associated With IgA Multiple Myeloma: a Case Report. J Cutan Pathol. 2010;37(11):1174-7. PubMed PMID: 19638068.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acquired bullous dermatosis associated with IgA multiple myeloma: a case report. AU - Barnadas,Maria A, AU - Gelpí,Carmen, AU - Martínez,Laura, AU - Curell,Román, AU - Martino,Rodrigo, AU - Alomar,Agustín, PY - 2009/7/30/entrez PY - 2009/7/30/pubmed PY - 2011/1/12/medline SP - 1174 EP - 7 JF - Journal of cutaneous pathology JO - J. Cutan. Pathol. VL - 37 IS - 11 N2 - We present the case of a patient with IgA paraprotein who developed hemorrhagic subepidermal vesicles and bullae with numerous neutrophils. Direct immunofluorescence test (DIF) showed weak deposits of IgA lambda paraprotein at the dermal-epidermal junction and at the intercellular level in the basal layer of the epidermis, and stronger deposits in a perivascular and diffuse pattern in the dermis. Indirect immunofluorescence (IIF) test revealed the presence of circulating IgA lambda antibodies reacting with the intercellular space of monkey and guinea pig esophagus and human skin. A blood test revealed an IgA lambda paraprotein and multiple myeloma stage I(0) was diagnosed in a later hematological study. Dapsone was prescribed and cutaneous lesions improved. This is the second report of subepidermal vesicles and bullae with dermal deposits of IgA paraprotein appearing prior to diagnosis of an IgA multiple myeloma, and it is a unique case with circulating IgA lambda antibodies reacting with the intercellular space of epithelia. SN - 1600-0560 UR - https://www.unboundmedicine.com/medline/citation/19638068/Acquired_bullous_dermatosis_associated_with_IgA_multiple_myeloma:_a_case_report_ L2 - https://doi.org/10.1111/j.1600-0560.2009.01383.x DB - PRIME DP - Unbound Medicine ER -