Waldenström Macroglobulinemia with an IgM-κ Antiepidermal Basement Membrane Zone Antibody

M. W. Cobb, N. Domloge-Hultsch, J. N. Frame, K. B. Yancey

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Abstract

Background.— Waldenström macroglobulinemia, a lymphoplasmacytoid cell malignant neoplasm associated with a monoclonal IgM paraprotein, has been associated with a number of cutaneous manifestations. On rare occasions, IgM deposits have been demonstrated in the epidermal basement zone of patients with WM. Observations.— We report the case of a patient with Waldenström macroglobulinemia and IgM-κ paraprotein who had development of an eruption of pruritic papules and demonstrated the following unusual immunopathologic findings: (1) deposits of IgM-κ in the epidermal basement membrane zone of lesional and nonlesional skin; (2) a circulating IgM-κ antiepidermal basement membrane zone antibody; and (3) binding of this circulating IgM-κ antiepidermal basement membrane zone antibody to both sides of 1 mol/L sodium chloride split skin. The cutaneous eruption cleared completely with oral psoralen with long-wave UV radiation in the A range (PUVA) therapy. Conclusions.— We present a patient with Waldenström macroglobulinemia who had a distinctive papular eruption and immunopathologic findings suggesting that his paraprotein has specificity for the epidermal basement membrane zone.

Original languageEnglish (US)
Pages (from-to)372-376
Number of pages5
JournalArchives of Dermatology
Volume128
Issue number3
DOIs
StatePublished - Mar 1992

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ASJC Scopus subject areas

  • Dermatology

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