A 64 year-old woman with a known history of multiple myeloma and widespread rash

    A 64 year-old woman, with a known history of multiple myeloma, presented at dermatologic clinic, with a disseminated rash, consisting of erythematous, flat, irregular shaped, various sized patches with barely palpable borders.

    Besides the erythematous rash, a yellow-orange colour was apparent on the palmar creases.

    A laboratory screening was performed that revealed, increase ESR (88mm/h), roleau formation by peripheral erythrocytes, a spike in the γ region on the serum protein electrophoresis, which represented an IgG κ- light chain mononoclonal immunoglobulin on immunofixation, presence of free κ- light chains on urine protein electrophoresis and immunofixation, bone marrow biopsy with an infiltration by well-differentiated plasma cells in a percentage of 35%, normal serum lipids and normal bone x-rays.