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December 1966

Cryoglobulinemia Presenting as "Factitial Ulceration"

Author Affiliations


From the Department of Dermatology, Hitchcock Clinic and the Department of Medicine, Dartmouth Medical School, Hanover, NH.

Arch Dermatol. 1966;94(6):725-731. doi:10.1001/archderm.1966.01600300049011

A case of "essential" cryoglobulinemia was initially misdiagnosed as factitial ulceration. The abnormal protein, not demonstrable on routine electrophoresis, was characterized as a macrocryoglobulin. A biologic false-positive reaction occurred with the venereal disease research laboratory test for syphilis (VDRL), and the Kolmer and fluorescent treponemal antibody (FTA-200) tests, but the Reiter protein complement fixation test (RPCF), fluorescent treponemal antibody test with serum absorbed by Reiter protein sonicate (FTA-abs), and Treponema pallidum immobilization test (TPI) were nonreactive. Pitfalls in diagnosis of cryoglobulinemia are enumerated. Clinical criteria for factitial ulceration are applied.

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