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Multiple myeloma is a plasma cell neoplasm associated with features of hypercalcemia, renal dysfunction and acquired immune abnormalities. We are reporting a rare case of an 80-year-old multiple myeloma patient with progressive disease with standard chemotherapy and developed cutaneous nodular lesion and pleural effusion. Biopsy of the skin nodule and pleural fluid cytology was suggestive of myelomatous infiltration. Simultaneous pleural and skin involvement is rarely reported in the literature. Such cases are scarcely reported, poorly understood and thus we intend to add to the scientific committee.