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Cutaneous Manifestations of Multiple Myeloma

Cutaneous Manifestations of Multiple Myeloma Abstract Multiple myeloma is characterized by either a focal or a diffuse abnormal overgrowth of plasma cells, occurring predominantly in the 40- to 70-year age group. Features of this disease, not dermatological, are (1) pain in the bones, (2) pathological fracture, (3) neurologic manifestations, (4) gastrointestinal symptoms, (5) fever, (6) splenomegaly and hepatomegaly, (7) lymphadenopathy, (8) extramedullary lesions, (9) roentgen abnormalities, (10) kidney abnormalities, and (11) pulmonary involvement. The characteristic cells of the relatively benign, chronic multiple myelomas are the "typical" plasma cells, according to Campbell and Good.1 They are characterized by four simultaneous structural features: 1. Heavy plaque-like chromatin aggregations in the nucleus, with sharp boundaries (in contradistinction to the chromatin lumps seen in lymphocytes); these account for the well-known cartwheel nucleus. 2. Intense basophilia of the cytoplasm. 3. The presence of a clear space in the nucleus, usually in the widest References 1. References 26 and 27. 2. References 5 and 37 to 45. 3. References 42, 43, 44, and 49. 4. Campbell, B., and Good, R. A.: Antigen-Antibody Mechanisms in Neurotropic Virus Diseases , Ann. Allergy 7:471 ( (July) -Aug.) 1949. 5. Schwartz, S. O.: Multiple Myeloma , Chicago Medical School Quart. 14:49 ( (Jan.) ) 1953. 6. Rostenberg, A., Jr., and Bluefarb, S. M.: Cutaneous Reactions in the Lymphoblastomas , A. M. A. Arch. Dermat. & Syph. 69:195 ( (Feb.) ) 1954. 7. Meacham, G. C.: Plasma Cell Myeloma , Ann. Int. Med. 38:1035 ( (May) ) 1953. 8. Hellwig, C. A.: Extramedullary Plasma Cell Tumors as Observed in Various Locations , Arch. Path. 36:95 ( (July) ) 1943. 9. Snapper, I., Turner, L. B., and Moscovitz, H. L.: Multiple Myeloma , New York, Grune & Stratton, Inc., 1953. 10. Lubarsch, O.: Zur Kenntnis ungewöhnlicher Amyloidablagerungen , Arch. Path. Anat. 271:867, 1929. 11. Bloch, B.: Über eine bisher nicht bescheribene mit eigentümlichen Elastinveränderungen einhergehende Dermatose bei Bence-Jonesscher Albuminurie: ein Beitrag zur Lehre von den Stoffwechseldermatosen , Arch. Dermat. u. Syph. 99:9, 1910. 12. Hayes, D. W.; Bennett, W. A., and Heck, F. J.: Extramedullary Lesions in Multiple Myeloma , A. M. A. Arch. Path. 53:262 ( (March) ) 1952. 13. Kreibich, C.: Plasmomyelom der Haut , Folia haemat. 18:94, 1914. 14. MacLeod, J. M. H.: Sections from a Case of Myeloma , Proc. Roy. Soc. Med. 19(Sect. Dermat.): 16, 1925-1926. 15. Nicholls, A. G.: Multiple Myeloma of Unusual Type with Widely Disseminated Metastases of Small Size , Canad. M. A. J. 17:301 ( (March) ) 1927. 16. Newns, G. R., and Edwards, J. L.: A Case of Plasma-Cell Myelomatosis with a Large Renal Metastasis and Widespread Tubular Obstruction , J. Path. & Bact. 56:259 ( (April) ) 1944. 17. Aragona, P.: Su di un caso di "plasmocitoma," Arch. ital. di anat. e istol. pat. 7:544, 1936 18. Switzer, P. K.; Mosely, V., and Cannon, W. M.: Extramedullary Plasmocytoma Involving Pharynx, Skin and Lymph Nodes , Arch. Int. Med. 86:402 ( (Sept.) ) 1950. 19. Piney, A., and Riach, J. S.: Multiple Myeloma: Aleukemic and Leukemic , Folia haemat. 46:37 ( (Dec.) ) 1931. 20. Lewis, H. M.; Henschel, E. J., and Frumess, G. M.: Extramedullary Plasmocytoma , A. M. A. Arch. Dermat. & Syph. 63:474 ( (April) ) 1951. 21. Jackson, H., Jr.; Parker, F., Jr., and Bethea, J. M.: Studies of Diseases of the Lymphoid and Myeloid Tissues. II. Plasmocytomata and Their Relation to Multiple Myelomata , Am. J. M. Sc. 181:169 ( (Feb.) ) 1931. 22. Duvoir, M.; Pollet, L.; Layani, F.; Dechaune, M., and Gaultier, M.: Myélomes multiples avec tumeurs cutanées , Bull. et mém. Soc. méd. hôp. Paris 54:687 ( (May 9) ) 1938. 23. Kin, S. S.: Beitrag zur Kenntnis der Kahlerschen Krankheit mit Mycosis fungoides, besonders über die Genese der Geschwulstzellen , Arch. jap. Chir. 16:79 ( (Jan. 1) ) 1939. 24. Christian, H. A.: Multiple Myeloma: A Histological Comparison of 6 Cases , J. Exper. Med. 9:325 ( (July) ) 1907. 25. Hedinger, E.: Zur Frage des Plasmocytoms Granulationsplasmocytom in Kombination mit einem krebsig umgewandelten Schweissdrüsenadenom des behaarten Kopfes , Ztschr. Path. 7:343, 1911. 26. Wuhrmann, F.; Wunderly, C., and Hugentobler, F.: Über die Kombination der Weltmann-Kalziumchloridhitzekoagulation mit der Kadmiumsulfattrübungsreaktion zur Abschätzung des Globulinunterfraktionen α, β1, β2 and γ , Deutsche med. Wchnschr. 74:1263, 1949.Crossref 27. Wells, G. C.: Primary Systematized Amyloidosis with Macroglossia , Brit. J. Dermat. 64:169 ( (May) ) 1952.Crossref 28. Mathews, W. H.: Primary Systemic Amyloidosis , Am. J. M. Sc. 228:317 ( (Sept.) ) 1954.Crossref 29. Robertson, T.: Plasmocytosis and Hyperglobulinemia as Manifestations of Hypersensitivity , Am. J. Med. 9:315, 1950.Crossref 30. Teilum, G.: Hyperglobulinemia, Periarterial Fibrosis of the Spleen, and the Wire Loop Lesions in Disseminated Lupus Erythematosus in Relation to Allergic Pathogenesis , Am. J. Path. 24:409, 1948. 31. Selikoff, I. J., and Robitzek, E. H.: Gingival Biopsy for the Diagnosis of Generalized Amyloidosis , Quart. Bull. Sea View Hosp. 8:310 ( (Oct.) ) 1946. 32. Michelson, H. E., and Lynch, F. W.: Systematized Amyloidosis of the Skin and Muscles , Arch. Dermat. & Syph. 29:805 ( (June) ) 1934. 33. Brunsting, L. A., and MacDonald, I. D.: Primary Systematized Amyloidosis with Macroglossia: a Syndrome Related to Bence-Jones Proteinuria and Myeloma , J. Invest. Dermat. 8:145 ( (March) ) 1947. 34. Koletsky, S., and Stecher, R. M.: Primary Systemic Amyloidosis: Involvement of Cardiac Valves, Joints, and Bones, with Pathologic Fracture of the Femur , Arch. Path. 27:267 ( (Feb.) ) 1939. 35. Weber, F. P.; Cade, S.; Scott, A. W., and Pulvertaft, R. J. V.: Systematized Atypical Amyloidosis with Macroglossia , Quart. J. Med. 7:211, 1938. 36. Bayrd, E. D., and Bennett, W. A.: Amyloidosis Complicating Myeloma , M. Clin. North America 34:1151 ( (July) ) 1950. 37. Goltz, R. W.: Systematized Amyloidosis , Medicine 31:381 ( (Dec.) ) 1952. 38. Rigdon, R. H.: Diffuse Amyloidosis of the Skin Accompanying Primary Systemic Amyloidosis , Am. Pract. 2:423 ( (Feb.) ) 1948. 39. Lerner, A. B., and Watson, C. J.: Studies of Cryoglobulins: I. Unusual Purpura Associated with the Presence of a High Concentration of Cryoglobulin (Cold Precipitable Serum Globulin) , Am. J. M. Sc. 214:410 ( (Oct.) ) 1947. 40. Waldenström, J.: Abnormal Proteins in Myeloma , in Advances in Internal Medicine , edited by W. Dock and I. Snapper, Chicago, The Year Book Publishers, Inc. 1952, Vol. 5, p. 398. 41. Hill, R. M.; Dunlop, S. G., and Mulligan, R. M.: Cryoglobulin Present in High Concentration in Plasma of Case of Multiple Myeloma , J. Lab. & Med. 34:1057 ( (Aug.) ) 1949. 42. Barr, D. P.; Reader, G. G., and Wheeler, C. H.: Cryoglobulinemia: I. Report of 2 Cases with Discussion of Clinical Manifestations, Incidence and Significance , Ann. Int. Med. 32:6 ( (Jan.) ) 1950. 43. Holmberg, C. G., and Grönwall, A.: Ein neues krystallinisches Serumglobulin , Ztschr. physiol. Chem. 273:199, 1942. 44. Packalen, T.: Case of Myeloma with Spontaneously Crystallizing Protein in Blood Serum and Urine , Acta med. scandinav. 100:1, 1939. 45. Flemberg, T., and Lehman, J., in Discussion of Waldenström, H. J.: Purpura Hyperglobulinemia , Nord. med. 23:1565, 1944. 46. Flemberg, T., Några fall med patologiskt förändrad blodäggvita , Nord. med. 37:330, 1948. 47. Rörvik, K.: Cryoglobulinemia: A Survey and Case Report , Acta med. scandinav. 137:390, 1950.Crossref 48. Hansen, P. F., and Faber, M.: Raynaud's Syndrome Originating from Reversible Precipitation of Protein , Acta med. scandinav. 129:81, 1947.Crossref 49. Wintrobe, M. M., and Buell, M. V.: Hyperproteinemia Associated with Multiple Myeloma, with a Report of a Case in Which an Extraordinary Hyperproteinemia Was Associated with Thrombosis of the Retinal Veins and Symptoms Suggesting Raynaud's Disease , Bull. Johns Hopkins Hosp. 52:156 ( (Feb.) ) 1933. 50. Hutchinson, J. H., and Howell, R. A.: Cryoglobulinemia: Report of a Case Associated with Gangrene of the Digits , Ann. Int. Med. 39:350 ( (Aug.) ) 1953.Crossref 51. Cugudda, E.: Plasmocitoma con criglobulinemia e trombosi arteriose e venose multiple , Minerva med. 2:205 ( (Aug. 9) ) 1952. 52. Steinhardt, M. J., and Fisher, G. S.: Cold Urticaria and Purpura as Allergic Aspects of Cryoglobulinemia , J. Allergy 24:335 ( (July) ) 1953.Crossref 53. Pelzig, A.: Essential Cryoglobulinemia with Purpura , A. M. A. Arch. Dermat. & Syph. 67: 429 ( (April) ) 1953. 54. Epstein, E., and MacEachern, K.: Dermatological Manifestations of the Lymphoblastoma-Leukemia Group , Arch. Int. Med. 60:867 ( (Nov.) ) 1937. 55. Allison, A., Jr., and Dick, A.: False-Positive Serological Reactions in Virus Pneumonia , Lancet , 2:364 ( (Aug. 21) ) 1954. 56. Soeborg-Ohlsen, A. and Nielsen, O. P.: Case of Leukemic Myelomatosis (Plasma Cell Leukemia) Acta med. scandinav. 122:271, 1945. 57. Haines, R. D.: Multiple Myeloma: Report of 51 Cases: Some Observations with Urethane Therapy , J. Louisiana M. Soc. 106:1 ( (Jan.) ) 1954. 58. Esser, H.: Über seltene Befunde beim Plasmocytom (Beitrag zur Purpura hyperglobulinaemica) , Ztschr. klin. Med. 146:535, 1950. 59. Limarzi, L. R.: Diagnostic and Therapeutic Aspects of Multiple Myeloma , M. Clin. North America 35:189 ( (Jan.) ) 1951. 60. James, T. N.; Monto, R. W., and Rebuck, J. W.: Thrombocytopenia and Abnormal Bleeding in Multiple Myeloma , Ann. Int. Med. 39:1281 ( (Dec.) ) 1953. 61. Patek, A. J., Jr., and Castle, W. B.: Plasma Cell Leukemia , Folia haemat. 52:369 ( (Nov.) ) 1934. 62. Ghon, A., and Roman, B.: Über pseudoleukämische und leukämische Plasmazellen-hyperplasie , Folia haemat. 15:72, 1913. 63. Osgood, E. E., and Hunter, W. C.: Plasma Cell Leukemia , Folia haemat. 52:369 ( (Nov.) ) 1934. 64. Spiethoff, cited by Hazen, H. H.: Skin Changes in the Leukaemias and Allied Conditions , J. Cut. Dis. 29:521, 1911. 65. Heidenström, N., and Tottie, M.: Haut- und Gelenkveränderungen bei multiplen Myelom , Acta dermat-venereol. 24:192 ( (Sept.) ) 1943. 66. Blades, A. N.: Cryoglobulinemia in multiple myelomatosis , Brit. M. J. 1:169 ( (Jan. 27) ) 1931.Crossref 67. Plenck, A. and Pretl, K.: Peripheres endobronchiales Plasmocytom der Lunge mit Osteopathia hypertrophicans , Wien. med. Wchnschr. 103:450 ( (June 20) ) 1953. 68. Kobro, M.: Further Observations of Zoster and Spinal Diseases , Acta med. scandinav. 104:1, 1940.Crossref 69. Sturgis, C. C.: Some Aspects of the Leukemia Problem , J. A. M. A. 150:1551 ( (Dec. 20) ) 1952.Crossref 70. Rundles, R. W.; Dillon, M. L., and Dillon, E. S.: Multiple Myeloma: III. Effect of Urethane Therapy on Plasma Cell Growth, Abnormal Serum Protein Components and Bence-Jones Proteinuria , J. Clin. Invest. 29:1243 ( (Sept.) ) 1950.Crossref 71. Harrington, W. J., and Moloney, W. C.: The Treatment of Multiple Myeloma with Urethane , Cancer 3:253 ( (March) ) 1950.Crossref 72. Saltzmann, F., and Borgström, H.: Multiple Plasmocytoma Treated with Urethane , Acta med. scandinav. 136:388, 1950.Crossref 73. Platzer, R. F.: Treatment of Multiple Myeloma , New York J. Med. 54:103 ( (Jan. 1) ) 1954. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Dermatology American Medical Association

Cutaneous Manifestations of Multiple Myeloma

A.M.A. Archives of Dermatology , Volume 72 (6) – Dec 1, 1955

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American Medical Association
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Copyright © 1955 American Medical Association. All Rights Reserved.
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0096-5359
DOI
10.1001/archderm.1955.03730360012002
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Abstract

Abstract Multiple myeloma is characterized by either a focal or a diffuse abnormal overgrowth of plasma cells, occurring predominantly in the 40- to 70-year age group. Features of this disease, not dermatological, are (1) pain in the bones, (2) pathological fracture, (3) neurologic manifestations, (4) gastrointestinal symptoms, (5) fever, (6) splenomegaly and hepatomegaly, (7) lymphadenopathy, (8) extramedullary lesions, (9) roentgen abnormalities, (10) kidney abnormalities, and (11) pulmonary involvement. The characteristic cells of the relatively benign, chronic multiple myelomas are the "typical" plasma cells, according to Campbell and Good.1 They are characterized by four simultaneous structural features: 1. Heavy plaque-like chromatin aggregations in the nucleus, with sharp boundaries (in contradistinction to the chromatin lumps seen in lymphocytes); these account for the well-known cartwheel nucleus. 2. Intense basophilia of the cytoplasm. 3. The presence of a clear space in the nucleus, usually in the widest References 1. References 26 and 27. 2. References 5 and 37 to 45. 3. References 42, 43, 44, and 49. 4. Campbell, B., and Good, R. A.: Antigen-Antibody Mechanisms in Neurotropic Virus Diseases , Ann. Allergy 7:471 ( (July) -Aug.) 1949. 5. Schwartz, S. O.: Multiple Myeloma , Chicago Medical School Quart. 14:49 ( (Jan.) ) 1953. 6. Rostenberg, A., Jr., and Bluefarb, S. M.: Cutaneous Reactions in the Lymphoblastomas , A. M. A. Arch. Dermat. & Syph. 69:195 ( (Feb.) ) 1954. 7. Meacham, G. C.: Plasma Cell Myeloma , Ann. Int. Med. 38:1035 ( (May) ) 1953. 8. Hellwig, C. A.: Extramedullary Plasma Cell Tumors as Observed in Various Locations , Arch. Path. 36:95 ( (July) ) 1943. 9. Snapper, I., Turner, L. B., and Moscovitz, H. L.: Multiple Myeloma , New York, Grune & Stratton, Inc., 1953. 10. Lubarsch, O.: Zur Kenntnis ungewöhnlicher Amyloidablagerungen , Arch. Path. Anat. 271:867, 1929. 11. Bloch, B.: Über eine bisher nicht bescheribene mit eigentümlichen Elastinveränderungen einhergehende Dermatose bei Bence-Jonesscher Albuminurie: ein Beitrag zur Lehre von den Stoffwechseldermatosen , Arch. Dermat. u. Syph. 99:9, 1910. 12. Hayes, D. W.; Bennett, W. A., and Heck, F. J.: Extramedullary Lesions in Multiple Myeloma , A. M. A. Arch. Path. 53:262 ( (March) ) 1952. 13. Kreibich, C.: Plasmomyelom der Haut , Folia haemat. 18:94, 1914. 14. MacLeod, J. M. H.: Sections from a Case of Myeloma , Proc. Roy. Soc. Med. 19(Sect. Dermat.): 16, 1925-1926. 15. Nicholls, A. G.: Multiple Myeloma of Unusual Type with Widely Disseminated Metastases of Small Size , Canad. M. A. J. 17:301 ( (March) ) 1927. 16. Newns, G. R., and Edwards, J. L.: A Case of Plasma-Cell Myelomatosis with a Large Renal Metastasis and Widespread Tubular Obstruction , J. Path. & Bact. 56:259 ( (April) ) 1944. 17. Aragona, P.: Su di un caso di "plasmocitoma," Arch. ital. di anat. e istol. pat. 7:544, 1936 18. Switzer, P. K.; Mosely, V., and Cannon, W. M.: Extramedullary Plasmocytoma Involving Pharynx, Skin and Lymph Nodes , Arch. Int. Med. 86:402 ( (Sept.) ) 1950. 19. Piney, A., and Riach, J. S.: Multiple Myeloma: Aleukemic and Leukemic , Folia haemat. 46:37 ( (Dec.) ) 1931. 20. Lewis, H. M.; Henschel, E. J., and Frumess, G. M.: Extramedullary Plasmocytoma , A. M. A. Arch. Dermat. & Syph. 63:474 ( (April) ) 1951. 21. Jackson, H., Jr.; Parker, F., Jr., and Bethea, J. M.: Studies of Diseases of the Lymphoid and Myeloid Tissues. II. Plasmocytomata and Their Relation to Multiple Myelomata , Am. J. M. Sc. 181:169 ( (Feb.) ) 1931. 22. Duvoir, M.; Pollet, L.; Layani, F.; Dechaune, M., and Gaultier, M.: Myélomes multiples avec tumeurs cutanées , Bull. et mém. Soc. méd. hôp. Paris 54:687 ( (May 9) ) 1938. 23. Kin, S. S.: Beitrag zur Kenntnis der Kahlerschen Krankheit mit Mycosis fungoides, besonders über die Genese der Geschwulstzellen , Arch. jap. Chir. 16:79 ( (Jan. 1) ) 1939. 24. Christian, H. A.: Multiple Myeloma: A Histological Comparison of 6 Cases , J. Exper. Med. 9:325 ( (July) ) 1907. 25. Hedinger, E.: Zur Frage des Plasmocytoms Granulationsplasmocytom in Kombination mit einem krebsig umgewandelten Schweissdrüsenadenom des behaarten Kopfes , Ztschr. Path. 7:343, 1911. 26. Wuhrmann, F.; Wunderly, C., and Hugentobler, F.: Über die Kombination der Weltmann-Kalziumchloridhitzekoagulation mit der Kadmiumsulfattrübungsreaktion zur Abschätzung des Globulinunterfraktionen α, β1, β2 and γ , Deutsche med. Wchnschr. 74:1263, 1949.Crossref 27. Wells, G. C.: Primary Systematized Amyloidosis with Macroglossia , Brit. J. Dermat. 64:169 ( (May) ) 1952.Crossref 28. Mathews, W. H.: Primary Systemic Amyloidosis , Am. J. M. Sc. 228:317 ( (Sept.) ) 1954.Crossref 29. Robertson, T.: Plasmocytosis and Hyperglobulinemia as Manifestations of Hypersensitivity , Am. J. Med. 9:315, 1950.Crossref 30. Teilum, G.: Hyperglobulinemia, Periarterial Fibrosis of the Spleen, and the Wire Loop Lesions in Disseminated Lupus Erythematosus in Relation to Allergic Pathogenesis , Am. J. Path. 24:409, 1948. 31. Selikoff, I. J., and Robitzek, E. H.: Gingival Biopsy for the Diagnosis of Generalized Amyloidosis , Quart. Bull. Sea View Hosp. 8:310 ( (Oct.) ) 1946. 32. Michelson, H. E., and Lynch, F. W.: Systematized Amyloidosis of the Skin and Muscles , Arch. Dermat. & Syph. 29:805 ( (June) ) 1934. 33. Brunsting, L. A., and MacDonald, I. D.: Primary Systematized Amyloidosis with Macroglossia: a Syndrome Related to Bence-Jones Proteinuria and Myeloma , J. Invest. Dermat. 8:145 ( (March) ) 1947. 34. Koletsky, S., and Stecher, R. M.: Primary Systemic Amyloidosis: Involvement of Cardiac Valves, Joints, and Bones, with Pathologic Fracture of the Femur , Arch. Path. 27:267 ( (Feb.) ) 1939. 35. Weber, F. P.; Cade, S.; Scott, A. W., and Pulvertaft, R. J. V.: Systematized Atypical Amyloidosis with Macroglossia , Quart. J. Med. 7:211, 1938. 36. Bayrd, E. D., and Bennett, W. A.: Amyloidosis Complicating Myeloma , M. Clin. North America 34:1151 ( (July) ) 1950. 37. Goltz, R. W.: Systematized Amyloidosis , Medicine 31:381 ( (Dec.) ) 1952. 38. Rigdon, R. H.: Diffuse Amyloidosis of the Skin Accompanying Primary Systemic Amyloidosis , Am. Pract. 2:423 ( (Feb.) ) 1948. 39. Lerner, A. B., and Watson, C. J.: Studies of Cryoglobulins: I. Unusual Purpura Associated with the Presence of a High Concentration of Cryoglobulin (Cold Precipitable Serum Globulin) , Am. J. M. Sc. 214:410 ( (Oct.) ) 1947. 40. Waldenström, J.: Abnormal Proteins in Myeloma , in Advances in Internal Medicine , edited by W. Dock and I. Snapper, Chicago, The Year Book Publishers, Inc. 1952, Vol. 5, p. 398. 41. Hill, R. M.; Dunlop, S. G., and Mulligan, R. M.: Cryoglobulin Present in High Concentration in Plasma of Case of Multiple Myeloma , J. Lab. & Med. 34:1057 ( (Aug.) ) 1949. 42. Barr, D. P.; Reader, G. G., and Wheeler, C. H.: Cryoglobulinemia: I. Report of 2 Cases with Discussion of Clinical Manifestations, Incidence and Significance , Ann. Int. Med. 32:6 ( (Jan.) ) 1950. 43. Holmberg, C. G., and Grönwall, A.: Ein neues krystallinisches Serumglobulin , Ztschr. physiol. Chem. 273:199, 1942. 44. Packalen, T.: Case of Myeloma with Spontaneously Crystallizing Protein in Blood Serum and Urine , Acta med. scandinav. 100:1, 1939. 45. Flemberg, T., and Lehman, J., in Discussion of Waldenström, H. J.: Purpura Hyperglobulinemia , Nord. med. 23:1565, 1944. 46. Flemberg, T., Några fall med patologiskt förändrad blodäggvita , Nord. med. 37:330, 1948. 47. Rörvik, K.: Cryoglobulinemia: A Survey and Case Report , Acta med. scandinav. 137:390, 1950.Crossref 48. Hansen, P. F., and Faber, M.: Raynaud's Syndrome Originating from Reversible Precipitation of Protein , Acta med. scandinav. 129:81, 1947.Crossref 49. Wintrobe, M. M., and Buell, M. V.: Hyperproteinemia Associated with Multiple Myeloma, with a Report of a Case in Which an Extraordinary Hyperproteinemia Was Associated with Thrombosis of the Retinal Veins and Symptoms Suggesting Raynaud's Disease , Bull. Johns Hopkins Hosp. 52:156 ( (Feb.) ) 1933. 50. Hutchinson, J. H., and Howell, R. A.: Cryoglobulinemia: Report of a Case Associated with Gangrene of the Digits , Ann. Int. Med. 39:350 ( (Aug.) ) 1953.Crossref 51. Cugudda, E.: Plasmocitoma con criglobulinemia e trombosi arteriose e venose multiple , Minerva med. 2:205 ( (Aug. 9) ) 1952. 52. Steinhardt, M. J., and Fisher, G. S.: Cold Urticaria and Purpura as Allergic Aspects of Cryoglobulinemia , J. Allergy 24:335 ( (July) ) 1953.Crossref 53. Pelzig, A.: Essential Cryoglobulinemia with Purpura , A. M. A. Arch. Dermat. & Syph. 67: 429 ( (April) ) 1953. 54. Epstein, E., and MacEachern, K.: Dermatological Manifestations of the Lymphoblastoma-Leukemia Group , Arch. Int. Med. 60:867 ( (Nov.) ) 1937. 55. Allison, A., Jr., and Dick, A.: False-Positive Serological Reactions in Virus Pneumonia , Lancet , 2:364 ( (Aug. 21) ) 1954. 56. Soeborg-Ohlsen, A. and Nielsen, O. P.: Case of Leukemic Myelomatosis (Plasma Cell Leukemia) Acta med. scandinav. 122:271, 1945. 57. Haines, R. D.: Multiple Myeloma: Report of 51 Cases: Some Observations with Urethane Therapy , J. Louisiana M. Soc. 106:1 ( (Jan.) ) 1954. 58. Esser, H.: Über seltene Befunde beim Plasmocytom (Beitrag zur Purpura hyperglobulinaemica) , Ztschr. klin. Med. 146:535, 1950. 59. Limarzi, L. R.: Diagnostic and Therapeutic Aspects of Multiple Myeloma , M. Clin. North America 35:189 ( (Jan.) ) 1951. 60. James, T. N.; Monto, R. W., and Rebuck, J. W.: Thrombocytopenia and Abnormal Bleeding in Multiple Myeloma , Ann. Int. Med. 39:1281 ( (Dec.) ) 1953. 61. Patek, A. J., Jr., and Castle, W. B.: Plasma Cell Leukemia , Folia haemat. 52:369 ( (Nov.) ) 1934. 62. Ghon, A., and Roman, B.: Über pseudoleukämische und leukämische Plasmazellen-hyperplasie , Folia haemat. 15:72, 1913. 63. Osgood, E. E., and Hunter, W. C.: Plasma Cell Leukemia , Folia haemat. 52:369 ( (Nov.) ) 1934. 64. Spiethoff, cited by Hazen, H. H.: Skin Changes in the Leukaemias and Allied Conditions , J. Cut. Dis. 29:521, 1911. 65. Heidenström, N., and Tottie, M.: Haut- und Gelenkveränderungen bei multiplen Myelom , Acta dermat-venereol. 24:192 ( (Sept.) ) 1943. 66. Blades, A. N.: Cryoglobulinemia in multiple myelomatosis , Brit. M. J. 1:169 ( (Jan. 27) ) 1931.Crossref 67. Plenck, A. and Pretl, K.: Peripheres endobronchiales Plasmocytom der Lunge mit Osteopathia hypertrophicans , Wien. med. Wchnschr. 103:450 ( (June 20) ) 1953. 68. Kobro, M.: Further Observations of Zoster and Spinal Diseases , Acta med. scandinav. 104:1, 1940.Crossref 69. Sturgis, C. C.: Some Aspects of the Leukemia Problem , J. A. M. A. 150:1551 ( (Dec. 20) ) 1952.Crossref 70. Rundles, R. W.; Dillon, M. L., and Dillon, E. S.: Multiple Myeloma: III. Effect of Urethane Therapy on Plasma Cell Growth, Abnormal Serum Protein Components and Bence-Jones Proteinuria , J. Clin. Invest. 29:1243 ( (Sept.) ) 1950.Crossref 71. Harrington, W. J., and Moloney, W. C.: The Treatment of Multiple Myeloma with Urethane , Cancer 3:253 ( (March) ) 1950.Crossref 72. Saltzmann, F., and Borgström, H.: Multiple Plasmocytoma Treated with Urethane , Acta med. scandinav. 136:388, 1950.Crossref 73. Platzer, R. F.: Treatment of Multiple Myeloma , New York J. Med. 54:103 ( (Jan. 1) ) 1954.

Journal

A.M.A. Archives of DermatologyAmerican Medical Association

Published: Dec 1, 1955

References