Perianal condyloma-like lesions in multiple myeloma associated amyloidosis

Systemic types of amyloidosis include those associated with plasma cell dyscrasia, as in multiple myeloma. Here we describe a 57-year-old woman who was diagnosed as having multiple myeloma IgG lambda. Six months after the diagnosis of myeloma, mucocutaneous lesions began to develop, with ecchymoses in the body folds and eyelid and periorbital purpura. Pedunculated condylomatous tumours began to develop in the perianal area. The excisional biopsy of a perianal nodule revealed a faintly eosinophilic, amorphous material replacing almost the entire dermis, in association with ectatic, endothelial-lined vascular spaces. The dermal deposits showed affinity with Congo Red stain. There were no histopathological features typical of condylomata acuminata. A diagnosis of cutaneous myeloma-associated amyloidosis was established. To our knowledge, this is the second reported case of condyloma-like perianal lesions in multiple myeloma-associated amyloidosis.