Localized cutaneous mucinosis associated with multiple myeloma: a rare presentation

Area of Science:

• Dermatology
• Hematology
• Oncology

Background:

• Lichen myxoedematosus (LM) is a primary cutaneous mucinosis with localized (papular mucinosis) and diffuse (scleromyxoedema) forms.
• The diffuse form is typically linked to monoclonal gammopathy, while the localized form usually is not.

Purpose of the Study:

• To report an atypical case of localized LM associated with multiple myeloma.
• To highlight the importance of considering underlying hematological malignancies in atypical presentations of cutaneous mucinoses.

Main Methods:

• Histopathological examination confirmed cutaneous mucinosis.
• Diagnostic workup for multiple myeloma included biochemical tests, imaging, and bone marrow biopsy.
• Treatment involved a standard regimen for multiple myeloma.

Main Results:

• A 66-year-old male presented with asymptomatic waxy papular eruption consistent with localized LM.
• The patient developed symptoms indicative of multiple myeloma, including encephalopathy, hypercalcemia, and lytic bone lesions.
• Bone marrow biopsy confirmed multiple myeloma.
• Treatment with bortezomib and dexamethasone resulted in complete resolution of skin lesions.

Conclusions:

• Localized Lichen myxoedematosus can rarely be associated with multiple myeloma.
• Early diagnosis and treatment of the underlying multiple myeloma are crucial for managing associated cutaneous manifestations.
• This case underscores the need for a comprehensive diagnostic approach in patients with atypical presentations of primary cutaneous mucinoses.