Bullous amyloidosis

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Although bullous amyloid lesions are very rare, the cutaneous lesions of this type can be a crucial manifestation of plasma cell dyscrasia. [Case Report] A 66-year-old man with a six-year history of multiple myeloma (IgG-λ, λ-type Bence Jones proteins) was admitted to the hospital because of hemorrhagic bullous lesions of the skin, chronic diarrhea and general malaise. A diagnosis of myeloma-associated amyloidosis with renal failure was made. One month later, he died as a consequence of progressive renal failure and systemic amyloidosis. A postmortem examination revealed myelomatous infiltrations (bone marrow and kidneys) and widespread amyloid deposits (skin, heart, lungs, kidneys, liver and intestine). The histologic examination of a bullous lesion showed amyloid deposits with formation of an intradermal blister.