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Comment & Response |

The Cause of Follicular Spicules in Multiple Myeloma

Gregory A. Hosler, MD, PhD1; Lisa Weibel, MD2; Richard C. Wang, MD, PhD1
[+] Author Affiliations
1Department of Dermatology, University of Texas Southwestern Medical Center, Dallas
2Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
JAMA Dermatol. 2015;151(4):457-458. doi:10.1001/jamadermatol.2014.4379.
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To the Editor Hyperkeratotic spicules may develop as a paraneoplastic syndrome of multiple myeloma. These follicular spicules in multiple myeloma (FSMM) are composed of precipitates of monoclonal dysproteins identical to the serum protein found in these patients.1 Light microscopy of the affected follicular epithelium shows intercellular deposits of eosinophilic material that has been identified as IgG by direct immunofluorescence.1 Trichodysplasia spinulosa (TS) is a distinct disorder that also presents with follicular spicules in the setting of immunosuppression.2 There is increasing evidence that the TS polyomavirus (TSPyV) is involved in the pathogenesis of TS.3

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January 1, 2015
Sander van Boheemen, MSc; Terry Jones, PhD; Barbara Muhlemann, BSc; Mariet C. Feltkamp, PhD; Ron A. M. Fouchier, PhD; Enes Hajdarbegovic, MD
1Department of Viroscience, Erasmus Medical Centre, Rotterdam, the Netherlands
2Center for Pathogen Evolution, Department of Zoology, University of Cambridge, Cambridge, England
3Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands
4Department of Dermatology and Venereology, Erasmus Medical Centre, Rotterdam, the Netherlands
JAMA Dermatol. 2015;151(1):82-84. doi:10.1001/jamadermatol.2014.1616.
April 1, 2015
Ingrid Lopez-Lerma, MD, PhD; Jordi Mollet, MD; Vicente Garcia-Patos, MD, PhD
1Department of Dermatology, Hospital Universitari Vall d’Hebron, Barcelona, Spain
JAMA Dermatol. 2015;151(4):458-459. doi:10.1001/jamadermatol.2014.4382.
April 1, 2015
Sander van Boheemen, PhD; Ron A. M. Fouchier, PhD; Enes Hajdarbegovic, MD
1Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
2Department of Dermatology and Venereology, Erasmus Medical Center, Rotterdam, the Netherlands
JAMA Dermatol. 2015;151(4):458. doi:10.1001/jamadermatol.2014.4385.
April 1, 2015
Justin D. Richey, MD; Terrence Katona, DO; Jeffrey B. Travers, MD, PhD
1Department of Pathology, Indiana University School of Medicine, Indianapolis
1Department of Pathology, Indiana University School of Medicine, Indianapolis2Richard L. Roudebush Veteran’s Affairs Medical Center, Indianapolis, Indiana
3Department of Dermatology, Indiana University School of Medicine, Indianapolis
JAMA Dermatol. 2015;151(4):459. doi:10.1001/jamadermatol.2014.4388.
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