heavy chains and free kappa light chains. The CD4 cell count was 20/mm3. A biopsy specimen of the abdominal cutaneous nodules showed a tumoral proliferation in the dermis, consisting of round large cells with anisocaryosis of the nucleus containing numerous nucleoli. Immunohistochemical staining of the atypical plasma cells was positive for anti-IgA and κ sera (Fig 2). Epstein-Barr virus (EBV) DNA was detected by polymerase chain reaction (PCR) in the cutaneous biopsy specimen (the negative control for EBV PCR was performed on an EBV-negative B-lymphocyte cell line DG75). Immunofluorescence was negative for latency (EBNA2, LMP) and replication proteins (VCA, LMA), with a positive control performed on an EBV-positive B-lymphocyte cell line (B95). In situ hybridization was negative for EBER small RNA detection. A diagnosis of multiple myeloma was considered. Histologic examination and immunohistochemical staining of the skin biopsy specimen led to a diagnosis of secondary EMP secreting IgA κ. The skin involvement progressed rapidly, and a rapidly growing third nodule appeared in the left temporal region. Chemotherapy with melphalan and cortisone was initiated. After 3 cycles, the initial plasmacytomas had grown, and numerous other lesions had appeared on his arms, face, and chest. Osteolytic lesions appeared without hypercalcemia or renal failure. The patient died 3 weeks later. There is a broad spectrum of hematologic and immunologic abnormalities in HIV-1 infection. Although the incidence of B-cell–associated lymphomas is increased in HIV infection, fewer than 30 cases of multiple myeloma (MM) have been reported in persons infected with HIV.1-11 Unlike classic plasma cell tumors, the disease often has extramedullary involvement with unusual clinical presentation and a short latency period. Skin involvement is present in only 4% to 8% of HIVnegative patients11 with extramedullary plasmacytomas (EMPs). We describe a case of MM presenting with primary cutaneous plasmacytomas and spinal cord compression in a 53-year-old man positive for HIV.