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IgD myeloma with multiple cutaneous plasmacytomas

K Patel¹, P A Carrington, S Bhatnagar

¹Department of Medicine, Jamaica Hospital Medical Center, New York, USA.

Clinical and Laboratory Haematology

|July 29, 1998

Summary

Extramedullary cutaneous plasmacytoma, a rare skin manifestation of myeloma, can occur even when bone marrow plasma cells are low. This case highlights skin relapse in IgD myeloma despite a plateau phase.

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Area of Science:

Oncology
Dermatology
Hematology

Background:

Extramedullary cutaneous plasmacytoma is rare, often linked to underlying medullary plasmacytoma.
IgD myeloma is a specific subtype of multiple myeloma.

Observation:

A patient with IgD myeloma achieved a plateau phase after chemotherapy.
Over a year later, multiple fleshy nodular skin lesions appeared.
Skin biopsy confirmed myeloma relapse in the skin.

Findings:

The IgD paraprotein level remained stable (plateau phase).
Bone marrow examination showed minimal plasma cell infiltration (1% plasma cells).
Cutaneous relapse occurred independently of systemic disease markers.

Implications:

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This case underscores the possibility of isolated extramedullary relapse in the skin.
It highlights the importance of vigilant skin surveillance in myeloma patients.
Treatment involved systemic chemotherapy and local radiotherapy for the cutaneous lesions.