title: Myeloma-associated systemic amyloidosis presenting as chronic paronychia and palmodigital erythematous swelling and induration of the hands.
abstract: Mucocutaneous involvement occurs predominantly in primary systemic amyloidosis as well as in myeloma-associated systemic amyloidosis. It is rarely observed in other types of amyloidoses. Signs of such involvement may aid in the early diagnosis of the disease process. Herein, we describe a 64-year-old white male patient with myeloma-associated systemic amyloidosis in whom the disease presented with unique cutaneous lesions consisting of chronic paronychia and palmodigital erythematous swelling and induration of the hands. Following weekly regimens with prednisone (20 mg/day) and melphalan (2 mg/day) administered every 16 weeks, almost complete resolution of the cutaneous lesions was observed after 1 year of therapy. Also, in response to chemotherapy, modest regression of the myelomatous bone lesions and complete resolution of the underlying gammopathy occurred.
authors.affiliation: Department of Dermatology, University of Minnesota, Minneapolis, USA.
authors.forename: I
authors.initials: I
authors.lastname: Ahmed
authors.forename: J S
authors.initials: JS
authors.lastname: Cronk
authors.forename: C E
authors.initials: CE
authors.lastname: Crutchfield
authors.forename: M V
authors.initials: MV
authors.lastname: Dahl
mesh_terms: D000686:Amyloidosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D004890:Erythema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005938:Glucocorticoids / Q000008:administration & dosage; D006229:Hand Dermatoses / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010304:Paronychia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011241:Prednisone / Q000008:administration & dosage; D012008:Recurrence; D013997:Time Factors
chemical_list: D018906:Antineoplastic Agents, Alkylating; D005938:Glucocorticoids; D008558:Melphalan; D011241:Prednisone