Erythema elevatum diutinum and IgA paraproteinaemia: ‘a preclinical iceberg’

We report on a 59‐year‐old man with erythema elevatum diutinum, diagnosed 6 years ago with an associated IgA paraproteinaemia, and who has been observed for over 15 years. This patient showed a lack of correlation with the paraproteinaemia and the clinical severity of his disease. The technique of immunofixation electrophoresis is more sensitive than immunoelectrophoresis in identifying monoclonal immunoglobulins or light chains at very low concentrations in serum and urine. Dermatologists need to be made aware of this important tool in detecting such changes in patients with erythema elevatum diutinum at an early stage.