Cutis laxa (CL) syndrome is an inherited or acquired disorder due to abnormal production or destruction of dermal elastic fibers. Acquired forms may be localized or generalized and frequently are related to preceding inflammatory dermatoses or monoclonal gammopathies. Acral CL is an exceptional form of acquired localized CL that may indicate an underlying multiple myeloma.1- 6
Skin manifestations on fingertips. A, Soft, redundant, and loose skin change. B, Long-lasting depression after pressure application.
Histopathologic specimens. A, Biopsy specimen from the thumb of the right hand showing amorphous eosinophilic dermal deposits consistent with amyloid (hematoxylin-eosin, original magnification ×20). B, Apple green birefringence seen on polarized light microscopy following Congo red staining, confirming the presence of amyloid (original magnification ×400). C, Elastic fibers are almost absent in the papillary and reticular dermis of the involved skin (Verhoeff–van Gieson, original magnification ×100). D, Plasma cells showing lambda light chain restriction (arrow) (λ light chain, original magnification ×200).
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