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Comment & Response
April 2015

The Cause of Follicular Spicules in Multiple Myeloma—Reply

Author Affiliations
  • 1Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
  • 2Department of Dermatology and Venereology, Erasmus Medical Center, Rotterdam, the Netherlands
JAMA Dermatol. 2015;151(4):458. doi:10.1001/jamadermatol.2014.4385

In Reply We are grateful to our colleagues for their contribution in consolidating the available knowledge on follicular spicules in multiple myeloma (FSMM). Gathering evidence on rare disorders is hampered by nonuniform terminology and variations in methodology in addition to the limited number of cases. The great similarity between the clinical pictures of FSMM and trichodysplasia spinulosa (TS) has led to clinicians mistaking the 2 diagnoses.1 Our article2 describes the first exhaustive, robust, and modern method of virologic analysis, which enabled us to exclude the presence, and therefore direct involvement, of TS polyomavirus (TSPyV) in FSMM. It is surprising that this had not been attempted before, given the similarities between TS and FSMM.