Allergic contact dermatitis to nitroglycerin has been previously reported. A localized cutaneous burn-like reaction due to the transdermal device was recently described. We are presenting a case of recurrent allergic contact dermatitis due to nitroglycerin as well as to its delivery device, resulting in numerous patches of postinflammatory hypermelanosis at the sites of application.

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A 61-year-old female patient presented with osteolytic skeletal lesions. Open rib biopsy disclosed tumor tissue which consisted of two types of cells: massive infiltrates of poorly differentiated lymphoplasmacytic cells were surrounded by large deposits of differentiated plasma cells. Serum immunoglobulins were normal. No light chains could be found in the urine. An immunoperoxidase technique was employed to detect intracellular immunoglobulins. While the partially differentiated cells were negative, the plasma cells were stained strongly positive for kappa light chains.