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September 20, 2010

Bullous Amyloidosis Complicated by Cellulitis and Sepsis: A Case Report

Author Affiliations

Author Affiliations: Department of Dermatology, State University of New York (SUNY) Downstate Medical Center, Brooklyn (Dr Reddy); and Departments of Pathology (Drs Hoda and Chen) and Medicine (Drs Penstein and Wasil), North Shore–LIJ Health System, New York, New York.

Arch Dermatol. 2011;147(1):126-127. doi:10.1001/archdermatol.2010.381

A 78-year-old African American man was seen with a history of easy bruising for 1 year. Workup revealed free λ light chains in the serum and urine. After bone marrow biopsy, the patient was diagnosed as having multiple myeloma. He underwent chemotherapy with cyclophosphamide, bortezomib, and dexamethasone along with prophylaxis with sulfamethoxazole-trimethoprim, fluconazole, and acyclovir and began to show improvement.

However, 3 months into treatment, he was seen in the emergency department for septic shock. No source of infection was initially evident. Dermatology was consulted for evaluation of bullous skin lesions, which had been present for 2 weeks prior to admission. Although the patient had been seen by a physician during this time, no diagnostic studies or therapeutic measures to address his skin lesions were undertaken. His last chemotherapy treatment was 2 days prior to admission.

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