Follicular spikes are a very rare but highly characteristic cutaneous manifestation, often occurring in the early stages of multiple myeloma (or other gammopathies) (Requena L et al. 1995). They have also been described in association with renal failure and Crohn's disease.
Hiniwes. The clinical picture was previously described under the name"trichodysplasia spinulosa".
The pathophysiology of this disease is unclear.
The spike-like hyperkeratoses typically appear as follicular pointed hyperkeratotic elevations in the follicular openings of the face, most commonly on or around the nose and forehead (Smith MP et al 2o19).
Spiny hyperkeratosis in gammopathy must be differentiated differentially from paraneoplastic acrokeratosis the Bazex syndrome, especially since this syndrome has also been described in association with multiple myeloma (Kandemir Alibakan Ö et al. 2020).