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Primary amyloidosis-induced nail dystrophy

William Tausend1, Megan Neill, Brent Kelly

  • 1University of Texas Medical Branch.

Dermatology Online Journal
|January 25, 2014
PubMed

Insights

Primary amyloidosis, a plasma cell disorder, can manifest as unusual skin lesions. This case highlights subungual thickening and nail dystrophy as a rare presenting sign of this condition.

Area of Science:

  • Dermatology
  • Hematology
  • Pathology

Background:

  • Primary amyloidosis originates from monoclonal plasma cell proliferation.
  • Cutaneous manifestations can occur in primary amyloidosis.

Observation:

  • A 56-year-old male presented with chronic back pain and lower extremity weakness.
  • Examination revealed subungual verrucous plaques with nail dystrophy on both thumbs.

Findings:

  • Biopsy of the subungual lesions showed amorphous material deposition in the dermis.
  • Staining with Congo red and crystal violet confirmed amyloid deposition.
  • The patient was diagnosed with plasma cell dyscrasia and primary amyloidosis.

Implications:

  • This case represents a rare presentation of primary amyloidosis.
  • Subungual thickening and nail dystrophy may be indicative of underlying plasma cell dyscrasia.
  • Highlights the importance of dermatological examination in diagnosing systemic diseases.

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