Periorbital papules as a presenting sign in multiple myeloma with AL amyloidosis

A 67-year-old woman of Indian heritage with no significant medical history presented with a 9-month history of progressive periorbital lesions consisting of coalescing pigmented papules (figure 1A). On systems review she reported concurrent diarrhoea and weight loss. She was not in overt heart failure and had no other cutaneous lesions or macroglossia. Figure 1 (A) Confluent periorbital lesions. (B) Deposition of pink amorphous material on histological section. (C) …