Amyloidosis, Nodular Localized Cutaneous Follow-up

  • Author: Lauren Biesbroeck; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 5, 2010
 

Complications

  • Rarely, patients with nodular localized cutaneous amyloidosis develop systemic amyloidosis or multiple myeloma years later, suggesting the need for follow-up care.
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Prognosis

  • Nodular localized cutaneous amyloidosis typically is benign and limited to the skin. Progression to systemic disease is unlikely. Previous articles have reported progression rates as high as 50%.[2] However, a more recent review article reports that less than 15% of patients later developed systemic amyloidosis. Other, more recent case series have shown rates of progression of 7%.[3]
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Contributor Information and Disclosures
Author

Lauren Biesbroeck  Washington University in St Louis School of Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Gregory J Raugi, MD, PhD  Professor, Department of Internal Medicine, Division of Dermatology, University of Washington at Seattle; Chief, Dermatology Section, Primary and Specialty Care Service, Veterans Administration Medical Center of Seattle

Gregory J Raugi, MD, PhD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Catharine Lisa Kauffman, MD, FACP  Georgetown Dermatology and Georgetown Dermpath

Catharine Lisa Kauffman, MD, FACP is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Royal Society of Medicine, Society for Investigative Dermatology, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Warren R Heymann, MD  Head, Division of Dermatology, Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey

Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Hagari Y, Mihara M, Hagari S. Nodular localized cutaneous amyloidosis: detection of monoclonality of infiltrating plasma cells by polymerase chain reaction. Br J Dermatol. Oct 1996;135(4):630-3. [Medline].

  2. Kalajian AH, Waldman M, Knable AL. Nodular primary localized cutaneous amyloidosis after trauma: a case report and discussion of the rate of progression to systemic amyloidosis. J Am Acad Dermatol. Aug 2007;57(2 Suppl):S26-9. [Medline].

  3. Woollons A, Black MM. Nodular localized primary cutaneous amyloidosis: a long-term follow-up study. Br J Dermatol. Jul 2001;145(1):105-9. [Medline].

  4. Inazumi T, Hakuno M, Yamada H, et al. Characterization of the amyloid fibril from primary localized cutaneous nodular amyloidosis associated with Sjögren's syndrome. Dermatology. 1994;189(2):125-8. [Medline].

  5. Srivastava M. Primary cutaneous nodular amyloidosis in a patient with Sjögren's syndrome. J Drugs Dermatol. Mar 2006;5(3):279-80. [Medline].

  6. Yoneyama K, Tochigi N, Oikawa A, Shinkai H, Utani A. Primary localized cutaneous nodular amyloidosis in a patient with Sjögren's syndrome: a review of the literature. J Dermatol. Feb 2005;32(2):120-3. [Medline].

  7. Konishi A, Fukuoka M, Nishimura Y. Primary localized cutaneous amyloidosis with unusual clinical features in a patient with Sjögren's syndrome. J Dermatol. Jun 2007;34(6):394-6. [Medline].

  8. Meijer JM, Schonland SO, Palladini G, et al. Sjögren's syndrome and localized nodular cutaneous amyloidosis: coincidence or a distinct clinical entity?. Arthritis Rheum. Jul 2008;58(7):1992-9. [Medline].

  9. Summers EM, Kendrick CG. Primary localized cutaneous nodular amyloidosis and CREST syndrome: a case report and review of the literature. Cutis. Jul 2008;82(1):55-9. [Medline].

  10. Hicks BC, Weber PJ, Hashimoto K, Ito K, Koreman DM. Primary cutaneous amyloidosis of the auricular concha. J Am Acad Dermatol. Jan 1988;18(1 Pt 1):19-25. [Medline].

  11. Mun KS, Pailoor J, Reddy SC. Primary localised deep cutaneous amyloidosis of the eyelid. Malays J Pathol. Dec 2005;27(2):113-5. [Medline].

  12. Northcutt AD, Vanover MJ. Nodular cutaneous amyloidosis involving the vulva. Case report and literature review. Arch Dermatol. Apr 1985;121(4):518-21. [Medline].

  13. Moon AO, Calamia KT, Walsh JS. Nodular amyloidosis: review and long-term follow-up of 16 cases. Arch Dermatol. Sep 2003;139(9):1157-9. [Medline].

  14. Lien MH, Railan D, Nelson BR. The efficacy of dermabrasion in the treatment of nodular amyloidosis. J Am Acad Dermatol. Feb 1997;36(2 Pt 2):315-6. [Medline].

  15. Hamzavi I, Lui H. Excess tissue friability during CO2 laser vaporization of nodular amyloidosis. Dermatol Surg. Sep 1999;25(9):726-8. [Medline].

  16. Truhan AP, Garden JM, Roenigk HH Jr. Nodular primary localized cutaneous amyloidosis: immunohistochemical evaluation and treatment with the carbon dioxide laser. J Am Acad Dermatol. Jun 1986;14(6):1058-62. [Medline].

  17. Alster TS, Manaloto RM. Nodular amyloidosis treated with a pulsed dye laser. Dermatol Surg. Feb 1999;25(2):133-5. [Medline].

  18. Bozikov K, Janezic T. Excision and split thickness skin grafting in the treatment of nodular primary localized cutaneous amyloidosis. Eur J Dermatol. May-Jun 2006;16(3):315-6. [Medline].

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  20. Carroll CB, Collison DW, Rodman OG Jr. Atrophic outpouchings of abdominal skin. Nodular cutaneous amyloidosis. Arch Dermatol. Feb 1996;132(2):223-4, 226-7. [Medline].

  21. Grunewald K, Sepp N, Weyrer K, et al. Gene rearrangement studies in the diagnosis of primary systemic and nodular primary localized cutaneous amyloidosis. J Invest Dermatol. Oct 1991;97(4):693-6. [Medline].

  22. Helm TN, Danziger J, Helm KF. Bilateral plantar amyloidosis: a unique presentation of localized cutaneous amyloidosis. Cutis. Mar 1997;59(3):142-4. [Medline].

  23. Horiguchi Y, Takahashi C, Imamura S. A case of nodular cutaneous amyloidosis. Amyloid production by infiltrating plasma cells. Am J Dermatopathol. Feb 1993;15(1):59-63. [Medline].

  24. Huilgol SC, Ramnarain N, Carrington P, Leigh IM, Black MM. Cytokeratins in primary cutaneous amyloidosis. Australas J Dermatol. May 1998;39(2):81-5. [Medline].

  25. Kakani RS, Goldstein AE, Meisher I, Hoffman C. Nodular amyloidosis: case report and literature review. J Cutan Med Surg. Mar-Apr 2001;5(2):101-4. [Medline].

  26. Masuda C, Hayashi M, Kameda Y, Mohri S, Nakajima H, Nagai R. Protein AL origin in amyloidosis cutis nodularis atrophicans. J Dermatol. Aug 1986;13(4):280-4. [Medline].

  27. Masuda C, Mohri S, Nakajima H. Histopathological and immunohistochemical study of amyloidosis cutis nodularis atrophicans--comparison with systemic amyloidosis. Br J Dermatol. Jul 1988;119(1):33-43. [Medline].

  28. Touart DM, Sau P. Cutaneous deposition diseases. Part I. J Am Acad Dermatol. Aug 1998;39(2 Pt 1):149-71; quiz 172-4. [Medline].

  29. Trau H, Shpiro D, Schewach-Millet M, Pras M, Prelli F, Frangione B. Nodular cutaneous amyloidosis. Am J Dermatopathol. Aug 1991;13(4):414-7. [Medline].

  30. Vestey JP, Tidman MJ, Mclaren KM. Primary nodular cutaneous amyloidosis--long-term follow-up and treatment. Clin Exp Dermatol. Mar 1994;19(2):159-62. [Medline].

 
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The bright pink homogeneous-appearing material seen is amyloid stained with Congo red. A distinguishing feature of amyloid in the skin is an affinity to take up Congo red stain.
Amyloid shows apple green when examined with polarized light.
This transmission electron micrograph of amyloid deposited in the tissue shows loosely interwoven straight filaments.
 
 
 
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