A 59-year-old woman presented with multiple eruptive angiomatous papules that had appeared progressively on her trunk and extremities during the previous 10 months. Her medical history was significant for idiopathic thrombocytopenic purpura and multiple myeloma, which had been diagnosed 2 years earlier. She also had a history of persistent edema on her lower extremities and progressive mixed (motor and sensory) neuropathy.
Physical examination revealed 10 to 20 erythematous to violaceous, well-circumscribed, papulonodular lesions, measuring 0.5 to 1.0 cm in diameter, distributed over the neck, trunk, and extremities (Figure 1). The findings of the rest of the physical examination were unremarkable. A lesion was surgically excised and sent for histologic analysis (Figure 2 [hematoxylin-eosin] and Figure 3 [hematoxylin-eosin with periodic acid–Schiff]).
Ferran M, Gimenez-Arnau AM. Multiple Eruptive Angiomatous Lesions in a Patient With Multiple Myeloma—Quiz Case. Arch Dermatol. 2006;142(11):1501-1506. doi:10.1001/archderm.142.11.1501-d