Scleromyxedema: A Dramatic Response to Melphalan

A 65-year-old woman developed typical scleromyxedema, with the associated M-type abnormal serum protein and marrow plasmacytosis. Treatment with systemic melphalan resulted in a dramatic response. The dermatosis improved noticeably after one month and a biopsy taken after five months of therapy showed almost total restitution to normal. The response of the circulating paraprotein was slower, between four and seven months being required for an observable decrease to take place. The possible relationship between scleromyxedema and plasma cell myeloma is discussed.