A Case of Cryocrystalglobulinemia

Abstract

A Japanese male in his 60’s consulted our hospital for dark brownish lesions on both toes and heels. Purpura, erythema, livedo racemosa, and small ulcers were all observed in the lesions. His skin condition became aggravated in winter. Blood examination demonstrated increased cryoglobulin levels ; IgG-κ type I M protein, consistent with type I cryoglobulinemia. Histopathological ndings included many intravascular eosinophilic crystals. Immunohistological study demonstrated crystal-like bodies with positive expression of IgG and κ. We conrmed this case as cryocrystalglobulinemia in association with type I cryoglobulinemia. The skin lesions improved with rest and warmth, but later deteriorated. They later improved after prednisolone and cryoltration. As cryocrystalglobulinemia often becomes more severe than non-cryocrystalglobulinemia, treatment should be started immediately. Skin Research, 18 : 104-109, 2019