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April 11, 1977

IgM in Skin Lesions of Systemic Amyloidosis

JAMA. 1977;237(15):1598-1599. doi:10.1001/jama.1977.03270420066020

THE ASSOCIATION of systemic amyloidosis with monoclonal-component or M-component diseases such as multiple myeloma, Waldenström macroglobulinemia, lymphomas, and leukemia is well known. The purpose of this communication is to present a case of aleukemic chronic lymphocytic leukemia with an IgM paraprotein M-component associated with primary systemic amyloidosis in which IgM was found in the skin lesions on immunofluorescent staining.

Report of a Case  A 52-year-old man came to our clinic with a five-month history of an asymptomatic generalized eruption of waxy papules. The eruption was preceded by two months of a gradual progression of numbness and burning in all extremities and a weakness in both hands.On physical examination, numerous smooth, skin-colored, translucent papules (2 to 4 mm), several with a hemorrhagic component, were noted on the elbows, knees, calves, shins, wrists, buttocks, and ventral aspect of the upper extremities (Fig 1). There were two areas of linear purpura on