Localized Primary Cutaneous Nodular Amyloidosis in a Patient With Paraproteinemia

    March 2012 in “ Actas Dermo-Sifiliográficas ”
    M. Villar, María Eugènia Alegret i Burgués, José Luis Rodríguez-Peralto, R. Rivera, F. Vanaclocha
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    TLDR An elderly man with skin amyloidosis and abnormal blood proteins was monitored without finding widespread disease after 18 months.
    An 83-year-old man with a medical history of hypertension, type 2 diabetes, and hyperuricemia was diagnosed with localized primary cutaneous nodular amyloidosis (PLCNA) after presenting with skin lesions on his left lower limb. He had previously been diagnosed with monoclonal gammopathy of undetermined significance (MGUS) due to the presence of an IgG(K) paraprotein in his serum. Histopathological examination confirmed amyloid deposits in the skin, and immunohistochemical staining showed λ light-chain restriction, consistent with PLCNA. Despite the serum paraprotein, no amyloid was found in an abdominal fat biopsy, and there was no progression to myeloma or systemic amyloidosis after 18 months. The case highlights the need for careful monitoring of PLCNA patients with paraproteinemia for potential systemic disease progression.
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