Myeloma-associated systemic amyloidosis presenting as chronic paronychia and palmodigital erythematous swelling and induration of the hands

Mucocutaneous involvement occurs predominantly in primary systemic amyloido sis as well as in myeloma-associated systemic amyloidosis. It is rarely obs erved in other types of amyloidoses. Signs of such involvement may aid in t he early diagnosis of the disease process'. Herein, we describe a 64-year-o ld white male patient with myeloma-associated systemic amyloidosis in whom the disease presented with unique cutaneous lesions consisting of chronic p aronychia and palmodigital erythematous swelling and induration of the hand s. Following weekly regimens with prednisone (20 mg/day) and melphalan (2 m g/day) administered every 16 weeks, almost complete resolution of the cutan eous lesions was observed after 1 year of therapy. Also, in response to che motherapy, modest regression of the myelomatous bone lesions and complete r esolution of the underlying gammopathy occurred.