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 CASE REPORT
Year : 2006  |  Volume : 72  |  Issue : 6  |  Page : 437--439

Cutaneous vasculitis as a presenting feature of multiple myeloma: A report of 2 cases


Department of Dermatology, Venereology and Leprology, GS Medical College and KEM Hospital, Parel, Mumbai, India

Correspondence Address:
Uday Khopkar
Department of Dermatology, Venereology and Leprology, GS Medical College and KEM Hospital, Parel, Mumbai - 400 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0378-6323.29340

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We report two male patients who presented with symmetrical, painful purpura that evolved into bullae and necrotic ulcers, predominantly on the extremities, over two months in spite of conventional therapy including oral steroids. Examination showed livedoid and purpuric patches with necrotic centers in starburst pattern over the extremities and buttocks. The first case also had similar lesions over the ears. The clinical presentation and the histopathological examination suggested a diagnosis of necrotizing leukocytoclastic vasculitis (LCV). Blood testing ruled out connective tissue disease, hepatitis B or C infection or streptococcal infection as underlying cause of vasculitis. Serum antinuclear factor, antineutrophilic cytoplasmic antibody and anticardiolipin anticoagulant were negative in both cases. Cryoglobulins were positive in case 2. An incidental finding was raised serum proteins and globulins in case 2. Further investigations revealed M band on electrophoresis and features of multiple myeloma on bone marrow biopsy in both cases. These cases emphasize the importance of simple investigations like serum proteins in the evaluation of LCV.






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Online since 15th March '04
Published by Wolters Kluwer - Medknow