1
|
Liu JW, Tan Y, Chen T, Qian YT, Ma DL. Systemic amyloidosis presented with leonine facies. QJM 2024; 117:287-288. [PMID: 38060280 DOI: 10.1093/qjmed/hcad267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Indexed: 12/08/2023] Open
Affiliation(s)
- Jia-Wei Liu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Skin and Immune Diseases, Beijing 100730, China
| | - Yan Tan
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Skin and Immune Diseases, Beijing 100730, China
| | - Tian Chen
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Skin and Immune Diseases, Beijing 100730, China
| | - Yue-Tong Qian
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Skin and Immune Diseases, Beijing 100730, China
| | - Dong-Lai Ma
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Skin and Immune Diseases, Beijing 100730, China
| |
Collapse
|
2
|
Drumm C, O'Reilly M, McCartney Y, O'Kane M. Myeloma-associated AL amyloidosis presenting with nail dystrophy and scleroderma-like skin changes. Clin Exp Dermatol 2021; 47:491-493. [PMID: 34779033 DOI: 10.1111/ced.14983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/29/2022]
Affiliation(s)
- C Drumm
- Dermatology, Beaumont Hospital, Dublin, Ireland
| | - M O'Reilly
- Dermatology, Beaumont Hospital, Dublin, Ireland
| | - Y McCartney
- Histopathology, Beaumont Hospital, Dublin, Ireland
| | - M O'Kane
- Dermatology, Beaumont Hospital, Dublin, Ireland
| |
Collapse
|
3
|
Ahmad QM, Sultan SJ, Shah IH, Sameem F. Systemic amyloidosis presenting as mucocutaneous bullous lesions. Hematol Oncol Stem Cell Ther 2010; 2:418-21. [PMID: 20139056 DOI: 10.1016/s1658-3876(09)50011-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
A 65-year-old male presented with hemorrhagic bullous skin lesions with purpura and ecchymoses. There was increased skin fragility with a strongly positive Nikolsky sign. Histopathology of the skin revealed large amounts of amyloid deposits in the dermis with a positive Congo Red staining around the dermal vessels. Examination and tests in this patient also revealed anemia, hepatomegaly, infiltrative cardiomyopathy, polyneuropathy and immunoglobulin l deposition, favoring a diagnosis of primary amyloidosis (AL type). The present case is reported in view of the rarity of the bullous variant of primary systemic amyloidosis as well as presence of mucosal lesions and a positive Nikolsky sign.
Collapse
Affiliation(s)
- Qazi M Ahmad
- Government Medical College, Srinagar, Jammu and Kashmir, India
| | | | | | | |
Collapse
|
4
|
Stoopler ET, Alawi F, Laudenbach JM, Sollecito TP. Bullous amyloidosis of the oral cavity: A rare clinical presentation and review. ACTA ACUST UNITED AC 2006; 101:734-40. [PMID: 16731392 DOI: 10.1016/j.tripleo.2006.01.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2005] [Revised: 12/23/2005] [Accepted: 01/02/2006] [Indexed: 11/29/2022]
Abstract
Bullous amyloidosis (BA) is a rare cutaneous manifestation primarily of systemic amyloidosis, a disease in which abnormal proteinaceous material is formed and deposited in response to inflammatory conditions and plasma cell dyscrasias. Hemorrhagic bullae indicative of BA are usually associated with purpura and may be the initial clinical signs of systemic amyloidosis or monoclonal gammopathies, such as multiple myeloma and Waldenstrom's macroglobulinemia. Bullous amyloidosis of the oral cavity is highly uncommon and can mimic other vesiculobullous lesions of the oral mucosa. This article highlights an unusual case of oral BA and reviews important aspects of the disease.
Collapse
Affiliation(s)
- Eric T Stoopler
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, 240 South 40th Street, Philadelphia, PA 19104, USA.
| | | | | | | |
Collapse
|
5
|
|
6
|
BUEZO G, PORRAS J, FRAGA J, SANCHEZ E, ARAGüES M, DAUDÉEN E. Coexistence of diffuse plane normolipaemic xanthoma and amyloidosis in a patient with monoclonal gammopathy. Br J Dermatol 1996. [DOI: 10.1046/j.1365-2133.1996.d01-1022.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
7
|
BUEZO G, PORRAS J, FRAGA J, SANCHEZ E, ARAGüES M, DAUDÉEN E. Coexistence of diffuse plane normolipaemic xanthoma and amyloidosis in a patient with monoclonal gammopathy. Br J Dermatol 1996. [DOI: 10.1111/j.1365-2133.1996.tb01515.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
8
|
Poole S, Fenske NA. Cutaneous markers of internal malignancy. II. Paraneoplastic dermatoses and environmental carcinogens. J Am Acad Dermatol 1993; 28:147-64. [PMID: 8432911 DOI: 10.1016/0190-9622(93)70022-l] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A variety of cutaneous disorders may reflect the presence of an internal disease. The ability to recognize those that may indicate an underlying malignancy is of particular importance. In part I of this series malignant involvement of the skin, either direct or metastatic, and the genodermatoses with malignant potential were reviewed. In this portion, we describe the paraneoplastic dermatoses as well as the cutaneous effects of some environmental carcinogens associated with internal malignancy. In addition, several uncommon and controversial associations between benign dermatoses and internal malignant disease will be discussed.
Collapse
Affiliation(s)
- S Poole
- Division of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa 33612
| | | |
Collapse
|
9
|
Abstract
The clinical findings of familial amyloidosis of the Finnish type (FAF) were recorded in a series of 30 patients. The onset was in the 3rd or 4th decade with slow progression so that the majority was in good health still in the 7th decade. Decreased vision and corneal lattice dystrophy together with blepharochalasis were common. Signs of cranial neuropathy especially affecting the facial nerve were found in all and peripheral polyneuropathy mainly affecting the vibration and touch senses in 26 patients. Hypotrichosis, tongue and skin changes were also characteristic. Amyloid was found in all skin, sural nerve and muscle biopsies. FAF thus shows a triad of typical neurological, ophthalmological and dermatological manifestations distinct from other amyloidoses.
Collapse
Affiliation(s)
- S Kiuru
- Department of Neurology, University of Helsinki, Finland
| |
Collapse
|
10
|
Affiliation(s)
- R A Kyle
- Mayo Medical School, Rochester, Minnesota
| | | |
Collapse
|
11
|
Thomas CR, Rest EB, Brown CR. Rheumatologic manifestations of malignancy. MEDICAL AND PEDIATRIC ONCOLOGY 1990; 18:146-58. [PMID: 2406554 DOI: 10.1002/mpo.2950180212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The relationship between rheumatologic syndromes and cancer covers a very broad array of both common and distinctly rare manifestations. This discussion has outlined some of the known relationships that do exist. A high index of suspicion by both the primary care physician and subspecialist will enhance the probability of detecting cancer in the patient who may present with rheumatologic complaints.
Collapse
Affiliation(s)
- C R Thomas
- Department of Internal Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612
| | | | | |
Collapse
|
12
|
Abstract
Primary systemic amyloidosis (immunoglobulin light chain-derived) (AL) is an uncommon dysproteinemia with highly varied initial clinical manifestations. Among 153 patients with this disorder, the median survival was 20.4 months (5-year survival, 19.6%). The worst outcome was associated with overt congestive heart failure (median survival, 7.7 months; 5-year survival, 2.4%). The patients with the best outcome were those who had amyloid neuropathy without associated cardiac or renal involvement (median survival, 39.7 months; 5-year survival, 31.6%). Serum protein electrophoresis and immunoelectrophoresis are the most important tests because a monoclonal protein can be detected in almost two-thirds of the patients. When screening of both serum and urine is performed, a monoclonal protein is found in 86% of patients. Such screening is helpful if primary systemic amyloidosis is to be detected and treated early.
Collapse
Affiliation(s)
- M A Gertz
- Dysproteinemia Clinic, Mayo Clinic, Rochester, MN 55905
| | | |
Collapse
|
13
|
|
14
|
Pineda MS, Herrero C, Palou J, Vilalta A, Mascaró JM. Nail alterations in systemic amyloidosis: report of one case, with histologic study. J Am Acad Dermatol 1988; 18:1357-9. [PMID: 3385046 DOI: 10.1016/s0190-9622(88)80114-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
15
|
Abstract
Cutaneous lesions are present in up to 40% of patients with primary and myeloma-associated systemic amyloidosis and occur as a result of tissue deposition of immunoglobulin light chain material derived from a circulating paraprotein. The occurrence of waxy, purpuric mucocutaneous lesions provides a crucial early pointer to underlying occult plasma cell dyscrasia; the combination of the symptoms of the carpal tunnel syndrome, macroglossia, and specific mucocutaneous lesions is highly characteristic. Although secondary systemic (reactive) amyloidosis rarely gives rise to clinically evident cutaneous lesions, it may be etiologically related to a number of chronic dermatoses. Lesions of nodular primary localized cutaneous amyloidosis are indistinguishable from those of primary and myeloma-associated systemic amyloidosis, and they result from local plasma cell infiltration. Macular and papular (lichen amyloidosus) variants of primary localized cutaneous amyloidosis may have a familial or racial basis and are characterized by a tendency for keratinocytes to undergo filamentous degeneration and apoptosis. The prognosis of patients with plasma cell dyscrasia-related systemic amyloidosis remains poor, since there is little response to therapy with cytotoxic agents, colchicine, or dimethylsulfoxide. Colchicine is the drug of choice in the prevention and treatment of the renal amyloidosis associated with familial Mediterranean fever, and dimethylsulfoxide may be useful in the management of patients with secondary systemic amyloidosis. Macular amyloid and lichen amyloidosus generally follow a chronic course with intractable pruritus; there have been isolated reports of the beneficial effect of dermabrasion, topical dimethylsulfoxide, and therapy with the aromatic retinoid, etretinate.
Collapse
Affiliation(s)
- S M Breathnach
- Department of Medicine (Dermatology), Charing Cross and Westminster Medical School, London, U.K
| |
Collapse
|
16
|
|
17
|
Abstract
This review focuses on those systemic diseases or syndromes associated with monoclonal plasma cell disorders that may present with important cutaneous manifestations. Amyloidosis, POEMS syndrome, cutaneous plasmacytoma, xanthomas, benign hypergammaglobulinemic purpura of Waldenström, and scleromyxedema are emphasized.
Collapse
|
18
|
Holden CA, Weston MJ, MacDonald DM. Trauma-induced bullae; the presenting feature of systemic amyloidosis associated with plasma cell dyscrasia. Br J Dermatol 1982; 107:701-6. [PMID: 7171488 DOI: 10.1111/j.1365-2133.1982.tb00532.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
19
|
|
20
|
|