Primary Localized Cutaneous Nodular Amyloidosis Following Local Trauma

Primary localized cutaneous nodular amyloidosis (nodular amyloidosis) is a rare and distinct type of amyloidosis, in which amyloid L deposition is limited to the skin and typically manifested as a tumefactive nodule on the acral sites. However, the definite cause of nodular amyloidosis is still unknown. Although it is relatively well known that the amyloid deposits in nodular amyloidosis originate from immunoglobulin light chains secreted by local plasma cells, traumatic injury to the skin has rarely been recognized as a triggering factor of nodular amyloidosis. Herein, we present a case of a 50-year-old male patient with primary localized cutaneous nodular amyloidosis, which occurred after local trauma, and discuss the relationship between traumatic damage and dermal amyloid L deposition.

A Case of Nodular Cutaneous Amyloidosis / 대한피부과학회지

We report a rare form of the cutaneous amyloidosis, which presented as a solitary nodular lesion on the right cheek due to locally infiltrating plasma cells. Amyloid in nodular cutaneous amyloidosis is now considered to be derived from partly degenerated immunoglobulin light chain which is indistinguishable from those which may be deposited in the skin and other tissues secondary to a systemic amyloidosis. In our patient, there was no evidence of systemic involvement. The nodule was completely excised.

A Case of Nodular Cutaneous Amyloidosis / 대한피부과학회지

We report a rare form of the cutaneous amyloidosis, which presented as a solitary nodular lesion on the right cheek due to locally infiltrating plasma cells. Amyloid in nodular cutaneous amyloidosis is now considered to be derived from partly degenerated immunoglobulin light chain which is indistinguishable from those which may be deposited in the skin and other tissues secondary to a systemic amyloidosis. In our patient, there was no evidence of systemic involvement. The nodule was completely excised.

A Case of Primary Nodular Cutaneous Amyloidosis / 대한피부과학회지

Primary nodular cutaneous amyloidosis is a very rare type of amyloidosis, it must excluded the secondary nodular deposition of systemic amyloidosis. We report herein 47-year-old male with a erythematous waxy nodule on his parietal scalp for one year. Histopathologic examination showed homogenous amorphous eosinophilic deposition in the dermis with nodular fashion. In Congo red, amyloid material stained positively and showed apple-green birefringence with polarized light. On electron microscopic examination, extensive deposit of amyloid with typical 6-10 nm filament was confirmed. He had neither clinical nor laboratory evidence of systemic amyloidosis. We reviewed previously reported nodular amyloidosis in Korea.

A Case of Nodular Amyloidosis

A 38-year-old male patient visited our clinic complaining of three skin lesions on the scalp. There were yellowish to brownish, waxy, non-tender, walnut-sized nodules. Hematoxylin and eosin staining revealed amorphous pinkish material deposits in the dermis. The Congo red stain and Dylon stain under polarizing microscopy showed yellow-green birefringence and the immunoglobulin-lambda light chain stain showed a positive reaction. An electron microscopic examination revealed filaments with uniform diameter(6 to 10nm) that were straight and neither branched nor anastomosed. Based on the clinical, histopathological, immunohistochemical and electron microscopical findings, the skin lesions were diagnosed as nodular amyloidosis.

A case of nodular amyloidosis / 대한피부과학회지

Localized primary cuteneous nodular amyloidosis is the rarest form of the cutaneous amyloidosis, which appears as single or multiple nodules on the extremities, trunk, genitalia or face. A 44-Year-old woman had asymptomatic, translucent brown to pink papules and nodules on the toes for 5 years. Histopathologic exarnination showed deposition to pale, eosinophilic, amorphous material throughout the dermis, Under the electron microscope, the material consisted of straight, nonbranching, nonanastoimosing filaments. We thus made the diagnosis of nodular amyoidosis.

A Case of Nodular Amyloidosis

A 65-year-old female patient visited our clinic complaining of multiple skin lesions since one year ago. There were yellowish to brownish colored, bean to walnut-sized nodules on both lower extremities. Dylon stain with polarizing microscopy, immunohistochemical stain to amyloid P and immunoglobuhn-kappa chain showed positive reactivities but keratin stain was negative. According to histopathologic and immunohistochemical findings, she was diagnosed as nodular amyloidosis.