Waldenström macroglobulinemia-induced bullous dermatosis.
BACKGROUND
Waldenström macroglobulinemia is a plasma cell dyscrasia of undetermined cause characterized by the monoclonal proliferation of lymphoplasmacytes in the bone marrow, lymph nodes, and spleen and elevated circulating levels and tissue deposition of monoclonal IgM produced by these aberrant cells. Rarely, cutaneous manifestations of this disease have been reported.


METHODS
We report the case of a patient with bullous dermatosis induced by Waldenström macroglobulinemia and demonstrate the subepidermal location of the separation and the presence of IgM and kappa light chains by immunoperoxidase, immunofluorescent techniques, and electron microscopy with immunogold staining. Immunoblotting revealed a strong band at the 290-kd area.


CONCLUSIONS
The demonstration of the separation in the upper dermis at the site of IgM deposits suggests that these deposits may be an etiologic factor in this rare manifestation.
Department of Dermatology, University of Colorado Health Sciences Center, Denver, USA.
N Y
NY
West
J E
JE
Fitzpatrick
K M
KM
David-Bajar
S D
SD
Bennion
D000328:Adult; D005260:Female; D006801:Humans; D012872:Skin Diseases, Vesiculobullous / Q000209:etiology* / Q000473:pathology; D008258:Waldenstrom Macroglobulinemia / Q000150:complications*