Abstract
We report a case of a 71-year-old man with multiple myeloma complicated with psoriasis in which lesions were present on his lower legs. He had been given topical steroids for 3 years. The multiple myeloma was IgG, κ type. He had been given chemotherapy (VMCP, MMPP and AMCP) since March 1989 and interferon-α-2a (IFN-α-2a) since January 1988. Following several weeks of IFN-α-2a treatment, he developed erythemas with scales on his face, extremities, back, abdomen and hip. The histopathological findings of these lesions showed hyperkeratosis, parakeratosis, disappearance of the granular layers, and elongated rete ridges. A mild inflammatory infiltration was also present in the upper dermis and the papillae. These lesions improved after ceasing the IFN-α-2a injections and became exacerbated by reinjections of IFN-α-2a. He had been treated with β-blocker and angiotensin I converting enzyme antagonist for hypertension for past two years. Additionally, he had also been given diclofenac sodium for fever due to the injection of IFN-α-2a. All of these three drugs have the posibility of inducing psoriasis. Judging from his clinical course, the most likely factor influencing the psoriasis exacerbation was thought to be IFN-α-2a, although the possibility of synergism with the three drugs could not be excluded.
