We report a case of scleredema adultorum (Buschke's disease) associated with an IgA kappa monoclonal hypergammaglobulinaemia. A significant improvement in the skin was obtained with electron-beam therapy. Scleredema would appear to be linked to monoclonal hypergammaglobulinaemia, but the relationship between the skin disorder and the immunoglobulin abnormality remains to be elucidated.

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A 67-year-old patient with chronic myeloid leukemia for 4 years rapidly developed multiple squamous-cell carcinomas on the scalp. We discuss the role of chemotherapy, chronic immunosuppression, chronic sun exposure and of possible genetic factors.

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