Nail dystrophy and blisters as sole manifestations in myeloma-associated amyloidosis

We report the case of a 61-year-old Japanese man with IgG λ-type multiple myeloma, who presented with nail dystrophy as the initial manifestation of systemic amyloidosis. Subsequently he developed bullous amyloidosis. This report documents these two rare signs of systemic amyloidosis and demonstrates the precise location of cutaneous blister formation and amyloid deposition by fluorescence antigen mapping and electron microscopy.