Cargando…
Generalized Acquired Cutis Laxa Associated with Monoclonal Gammopathy of Dermatological Significance
BACKGROUND: Cutis laxa is a rare dermatosis that is inherited or acquired and clinically features loose, wrinkled, and redundant skin with decreased elasticity. This heterogeneous connective tissue disorder may be localized or generalized, with or without internal manifestations. Generalized cutis l...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7037480/ https://www.ncbi.nlm.nih.gov/pubmed/32099688 http://dx.doi.org/10.1155/2020/7480607 |
_version_ | 1783500437789343744 |
---|---|
author | Shalhout, Sophia Z. Nahas, Myrna R. Drews, Reed E. Miller, David M. |
author_facet | Shalhout, Sophia Z. Nahas, Myrna R. Drews, Reed E. Miller, David M. |
author_sort | Shalhout, Sophia Z. |
collection | PubMed |
description | BACKGROUND: Cutis laxa is a rare dermatosis that is inherited or acquired and clinically features loose, wrinkled, and redundant skin with decreased elasticity. This heterogeneous connective tissue disorder may be localized or generalized, with or without internal manifestations. Generalized cutis laxa often has a cephalocaudal progression and is attributed to inflammatory cutaneous eruptions, medications, and infections. Cutis laxa is also associated with several other conditions including rheumatoid arthritis, systemic lupus erythematosus, and plasma-cell dyscrasias. Case Presentation. We report an unusual case of a 35-year-old male with progression of generalized acquired cutis laxa and vasculitis that occurred over a period of one year. No cutaneous inflammatory eruption preceded or accompanied his decreased skin elasticity, and a biopsy of the skin showed elastolysis. His cutaneous manifestation led to systemic evaluation and an eventual diagnosis of smoldering multiple myeloma accompanied by aortitis and anemia. His myeloma and vasculitis were successfully treated with cyclophosphamide, bortezomib, and dexamethasone and high-dose prednisone, respectively, with no improvement to his cutis laxa. CONCLUSIONS: The presence of monoclonal gammopathy is strongly associated with several dermatological entities such as acquired cutis laxa. We propose a new term for the dermatological manifestations caused by paraproteinemia: monoclonal gammopathy of dermatological significance, or MGODS, and stress the evaluation of an underlying gammopathy in the setting of certain dermatologic conditions, including scleromyxedema and amyloidosis. We present a case of a newly acquired cutis laxa secondary to plasma-cell dyscrasias that exemplifies MGODS, alongside a brief literature review, and underscore the clinical relevance of monoclonal gammopathies of dermatological significance. |
format | Online Article Text |
id | pubmed-7037480 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-70374802020-02-25 Generalized Acquired Cutis Laxa Associated with Monoclonal Gammopathy of Dermatological Significance Shalhout, Sophia Z. Nahas, Myrna R. Drews, Reed E. Miller, David M. Case Rep Dermatol Med Case Report BACKGROUND: Cutis laxa is a rare dermatosis that is inherited or acquired and clinically features loose, wrinkled, and redundant skin with decreased elasticity. This heterogeneous connective tissue disorder may be localized or generalized, with or without internal manifestations. Generalized cutis laxa often has a cephalocaudal progression and is attributed to inflammatory cutaneous eruptions, medications, and infections. Cutis laxa is also associated with several other conditions including rheumatoid arthritis, systemic lupus erythematosus, and plasma-cell dyscrasias. Case Presentation. We report an unusual case of a 35-year-old male with progression of generalized acquired cutis laxa and vasculitis that occurred over a period of one year. No cutaneous inflammatory eruption preceded or accompanied his decreased skin elasticity, and a biopsy of the skin showed elastolysis. His cutaneous manifestation led to systemic evaluation and an eventual diagnosis of smoldering multiple myeloma accompanied by aortitis and anemia. His myeloma and vasculitis were successfully treated with cyclophosphamide, bortezomib, and dexamethasone and high-dose prednisone, respectively, with no improvement to his cutis laxa. CONCLUSIONS: The presence of monoclonal gammopathy is strongly associated with several dermatological entities such as acquired cutis laxa. We propose a new term for the dermatological manifestations caused by paraproteinemia: monoclonal gammopathy of dermatological significance, or MGODS, and stress the evaluation of an underlying gammopathy in the setting of certain dermatologic conditions, including scleromyxedema and amyloidosis. We present a case of a newly acquired cutis laxa secondary to plasma-cell dyscrasias that exemplifies MGODS, alongside a brief literature review, and underscore the clinical relevance of monoclonal gammopathies of dermatological significance. Hindawi 2020-02-12 /pmc/articles/PMC7037480/ /pubmed/32099688 http://dx.doi.org/10.1155/2020/7480607 Text en Copyright © 2020 Sophia Z. Shalhout et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Shalhout, Sophia Z. Nahas, Myrna R. Drews, Reed E. Miller, David M. Generalized Acquired Cutis Laxa Associated with Monoclonal Gammopathy of Dermatological Significance |
title | Generalized Acquired Cutis Laxa Associated with Monoclonal Gammopathy of Dermatological Significance |
title_full | Generalized Acquired Cutis Laxa Associated with Monoclonal Gammopathy of Dermatological Significance |
title_fullStr | Generalized Acquired Cutis Laxa Associated with Monoclonal Gammopathy of Dermatological Significance |
title_full_unstemmed | Generalized Acquired Cutis Laxa Associated with Monoclonal Gammopathy of Dermatological Significance |
title_short | Generalized Acquired Cutis Laxa Associated with Monoclonal Gammopathy of Dermatological Significance |
title_sort | generalized acquired cutis laxa associated with monoclonal gammopathy of dermatological significance |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7037480/ https://www.ncbi.nlm.nih.gov/pubmed/32099688 http://dx.doi.org/10.1155/2020/7480607 |
work_keys_str_mv | AT shalhoutsophiaz generalizedacquiredcutislaxaassociatedwithmonoclonalgammopathyofdermatologicalsignificance AT nahasmyrnar generalizedacquiredcutislaxaassociatedwithmonoclonalgammopathyofdermatologicalsignificance AT drewsreede generalizedacquiredcutislaxaassociatedwithmonoclonalgammopathyofdermatologicalsignificance AT millerdavidm generalizedacquiredcutislaxaassociatedwithmonoclonalgammopathyofdermatologicalsignificance |