Juliane Cabral Silva

Ulcerated plaque in the nasal dorsum in a patient with multiple myeloma

A 58-year-old white man presented with a 4-month history of a lesion on his nose. The patient had a history of multiple myeloma about 4 years previously, for which he had undergone bone-marrow transplantation the following year. Despite treatment with cyclophosphamide and dexamethasone, his haematological status had worsened and he had developed pathological fractures in his lumbar spine and pelvis. On physical examination, an ulcerated plaque was seen on the patient’s nose, with pearly raised edges and an erythematous halo on the nasal dorsum, initially suggestive of a basal cell carcinoma (Fig. 1). Dermatoscopy of the lesion showed an inflammatory pattern, without definitive features of cancer. A biopsy was taken for histological examination.