Pyoderma gangrenosum and subcorneal pustular dermatosis: clues to underlying immunoglobulin a myeloma

Skin signs that suggest underlying systemic disease provide important diagnostic opportunities. Six patients have been reported with concurrent subcorneal pustular dermatosis (SCPD) and pyoderma gangrenosum(PG).1–6 Five of the six also had immunoglobulin A (IgA) monoclonal gammopathy; none had myeloma. In this report, we present a patient in whom the striking association of SCPD and PG led to the finding of IgA multiple myeloma.