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Dermatology · Papulosquamous disorders: scleromyxoedema
Sample itemA middle-aged man has widespread firm, waxy, closely set papules on the face, neck and arms, producing a leonine look and stiff fingers. There is no thyroid disease and no Raynaud phenomenon. Which laboratory finding is expected?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Monoclonal IgG lambda paraprotein
Scleromyxoedema is a generalised lichen myxoedematosus with mucin deposition and almost always an IgG-lambda paraprotein. Intravenous immunoglobulin is an effective treatment.
Option by option
A. Monoclonal IgG lambda paraprotein (correct)
Correct. Scleromyxoedema is associated with an IgG lambda paraprotein.
B. Anti-centromere antibody
Anti-centromere antibodies are seen in limited systemic sclerosis.
C. Raised TSH
Raised TSH would suggest hypothyroidism, which is not part of this disease.
D. Anti-Scl-70 antibody
Anti-Scl-70 is a marker of diffuse systemic sclerosis.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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