Elastolytic cutaneous lesions in myeloma-associated amyloidosis.

Elastolytic cutaneous lesions were the initial manifestation of amyloidosis in two patients with multiple myeloma. The skin of the fingertip was noticeably soft, loose, and redundant. The skin of the fingers was depressed with pressure and remained depressed for an abnormally long period of time. Amyloid deposition in the dermis was demonstrated in both cases. In addition, fragmentation and a decrease of elastic fibers in the dermis were observed. Possible explanations for the pathogenesis of such skin lesions were also discussed.