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Dermatology consultation was sought for a 55-year-old man with asymptomatic generalised skin nodules, admitted under haematology for suspected multiple myeloma (MM). On examination, multiple skin-coloured to erythematous to violaceous, shiny, discrete papules and dome-shaped nodules with a firm consistency and waxy smooth feel, measuring 1–5 cm, were seen on the limbs and trunk (figure 1A–G). Dermoscopy revealed a central homogeneous pink area studded with linear and serpiginous vessel network which was accentuated at the periphery forming a rim of vessel network (figure 2A). A 4 mm punch biopsy of cutaneous nodule over the trunk showed diffuse infiltration of the dermis by sheets of plasma cells, including immature, mature and binucleate forms (figure 2B). On immunohistochemistry, the plasma cells were positive for CD138 (figure …
Contributors Each author has contributed sufficiently. AB: preparation of the manuscript, clicked photographs and did dermoscopy. SV: preparation, revision of the manuscript and patient management. SK: preparation, revision of the manuscript, guidance and described dermoscopic finding. HM: preparation, revision and supervision of the manuscript. NK: made the histopathological diagnosis and provided photomicrographs. NH : preparation, revision and submission of the manuscript and guidance. UKN: preparation, revision of the manuscript, guidance and overall patient management.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Next of kin consent obtained.
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