Clutter Courtney A, Aneja Savina, Ivan Doina, Ciurea Ana, Silapunt Sirunya
Internal Medicine, San Antonio Military Medical Center, San Antonio, USA.
Advanced Dermatology and Cosmetic Surgery, University of Central Florida, Orlando, USA.
Cureus. 2020 Nov 3;12(11):e11313. doi: 10.7759/cureus.11313.
Cutaneous involvement in multiple myeloma (MM) is a rare manifestation, being more prevalent in patients with aggressive subtypes, and refractory to standard therapies. Due to the rarity of this diagnosis, the reported clinical characteristics have been protean and relatively non-specific. Lower extremity involvement of cutaneous MM is an uncommon anatomical location for this diagnosis. We present a patient with refractory IgG lambda MM, and a past medical history of squamous cell carcinoma of the lower extremities who developed cutaneous MM in his lower leg. At the time of initial evaluation, the lesions mimicked squamous cell carcinoma, posing a diagnostic challenge. Histopathological and immunohistochemical studies confirmed cutaneous involvement by multiple myeloma. There needs to be a high clinical suspicion for cutaneous MM in patients with MM presenting with new skin lesions.
皮肤型多发性骨髓瘤（MM）是一种罕见的表现形式，在侵袭性亚型患者中更为常见，且对标准治疗耐药。由于这种诊断较为罕见，所报道的临床特征多样且相对不具特异性。皮肤型MM累及下肢是该诊断中不常见的解剖部位。我们报告一例难治性IgG λ型MM患者，既往有下肢鳞状细胞癌病史，其小腿部出现了皮肤型MM。在初始评估时，病变类似鳞状细胞癌，带来了诊断挑战。组织病理学和免疫组化研究证实为多发性骨髓瘤累及皮肤。对于出现新发皮肤病变的MM患者，需要对皮肤型MM有高度的临床怀疑。
