A rare dermatological manifestation of follicular spicules in a patient with multiple myeloma and end-stage renal disease on hemodialysis: A case report.

Multiple myeloma (MM) is a hematological malignancy characterized by the clonal expansion of malignant plasma cells within the bone marrow, leading to diverse systemic complications. While cutaneous manifestations of MM are uncommon, follicular spicules represent a highly specific but rare dermatological finding associated with MM. The present study presents the case of a 59-year-old man with MM who exhibited follicular acanthosis and hyperkeratosis as cutaneous indicators of the malignancy. The patient, with a history of stage 5 chronic kidney disease undergoing maintenance hemodialysis, was diagnosed with follicular spicules of MM (FSMM) through clinical evaluation and laboratory investigations. The present case highlights the clinical importance of recognizing rare cutaneous manifestations in MM, which can serve as critical diagnostic clues. Improved awareness of FSMM may facilitate a timely diagnosis and optimize patient management, ultimately contributing to improved clinical outcomes in this challenging population.