Nodular Localized Cutaneous Amyloidosis Clinical Presentation

Updated: Jul 06, 2020
  • Author: Nicholas V Nguyen, MD; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

The patient history may include the following:

  • Nodular localized cutaneous amyloidosis lesions usually are asymptomatic.

  • Patients can present with single or multiple lesions.

  • In some reports, lesions were present for several years before patients sought medical attention.

  • Troublesome aspects of nodular localized cutaneous amyloidosis primarily result from patient concerns about appearance, although plaques eventually fissured in one patient in whom the plantar aspects of the feet were affected.

  • Up to 25% of reported cases of NLCA have been in patients with Sjögren syndrome. [15]

  • In some cases, patients have given a history of preceding trauma. [4, 16, 17]

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Physical Examination

Physical examination may reveal the following:

  • Firm nodules can present at any cutaneous site including the face, scalp, extremities, trunk, and genitalia; however, acral areas are preferentially involved. [18, 19, 20, 21]

  • Nodules vary from a few millimeters to a few centimeters and may coalesce to form larger plaques.

  • Disseminated cases have been described. [22]

  • Nodules appear pink to brown or red.

  • Underlying epidermal atrophy has been described.

  • Other terms that describe the various lesions of nodular localized cutaneous amyloidosis include waxy, purpuric, yellowish, or bullous.

  • Lesions tend not to ulcerate, although a case of localized ulcerative nodular amyloidosis with deep involvement was described. [23]

  • Nodular localized cutaneous amyloidosis lacks extracutaneous findings by definition; however, one patient reported to have nodular localized cutaneous amyloidosis had amyloid deposits in the rectum.

  • Macroglossia, a typical feature of systemic amyloidosis, is not seen in nodular localized cutaneous amyloidosis.

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