From scleredema to AL amyloidosis: disease progression or coincidence? Review of the literature.
Scleredema (also called scleredema of Buschke) is a fibromucinous connective tissue disorder of unknown cause that belongs to a group of scleroderma-like disorders. We report the case of a 64-year-old lady with long-standing scleredema, associated with a paraprotein, and progressing to multiple myeloma and AL amyloidosis. The relationship of scleredema with paraprotein and multiple myeloma is well established, but only two cases of scleredema associated with amyloidosis have been reported to date. We suggest that amyloidosis may be underdiagnosed in patients with scleredema and paraproteinaemia. Features attributed to extracutaneous manifestations of scleredema could represent systemic amyloidosis. We review published reports of scleredema associated with paraprotein and discuss the difficulties in the differential diagnosis of scleroderma-like disorders. We discuss the diagnosis of plasma cell dyscrasias and amyloidosis and their relevance in rheumatology practice.
Dziadzio
Magdalena
M
Centre for Rheumatology, Royal Free and University College Medical School, University College, Rowland Hill Street, London, NW 32PF, UK.
Anastassiades
Constantinos P
CP
Hawkins
Philip N
PN
Potter
Michael
M
Gabrielli
Armando
A
Brough
Geraldine M
GM
Black
Carol M
CM
Denton
Christopher P
CP
D000686:Amyloidosis / Q000209:etiology* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000209:etiology / Q000473:pathology; D010265:Paraproteinemias / Q000150:complications / Q000473:pathology; D012592:Scleredema Adultorum / Q000150:complications* / Q000473:pathology
Br J Dermatol. 2000 Apr;142(4):781-3
10792232
Br J Haematol. 2003 Jun;121(5):749-57
12780789
Int J Dermatol. 2001 Nov;40(11):720-1
11737441
Clin Exp Dermatol. 1988 Jul;13(4):271-4
3149919
Br J Dermatol. 1997 Jun;136(6):939-42
9217831
Hautarzt. 1998 Jan;49(1):48-54
9522193
Kidney Int. 1993 Oct;44(4):834-6
7505040
Medicina (B Aires). 1998;58(5 Pt 1):501-3
9922484
J Nucl Med. 1998 Apr;39(4):699-706
9544684
Joint Bone Spine. 2002 Dec;69(6):538-45
12537260
Acta Derm Venereol. 1979;59(2):182-3
84503
Mayo Clin Proc. 1983 Oct;58(10):665-83
6353084
Am J Med. 1987 Mar;82(3):412-4
2435149
J Clin Pathol. 1988 Jul;41(7):776-85
3045160
J Invest Dermatol. 1978 Jun;70(6):305-8
349088
Arch Dermatol. 1981 Sep;117(9):536-9
6794460
Arthritis Rheum. 1989 Jan;32(1):82-5
2912466
Br J Dermatol. 1994 May;130(5):669-70
8204480
Br J Dermatol. 2000 Aug;143(2):450-2
10951166
Arch Dermatol Forsch. 1974 Feb 20;248(4):379-85
4134830
Semin Cutan Med Surg. 1998 Mar;17(1):65-76
9512109
Br J Dermatol. 1994 Mar;130(3):394-7
8148285
Arch Intern Med. 1988 Mar;148(3):551-3
2449145
Arch Dermatol. 1987 Feb;123(2):226-9
3813596
Dermatologica. 1983;166(5):240-6
6409682
J Am Acad Dermatol. 1999 Apr;40(4):507-35; quiz 536-8
10188670
Hautarzt. 1965 Jun;16(6):266-8
5838441
J Am Acad Dermatol. 1992 Feb;26(2 Pt 2):319-21
1569250
Ann Dermatol Venereol. 1997;124(8):537-9
9740847
Eur J Nucl Med. 1995 Jul;22(7):595-9
7498219
Mayo Clin Proc. 2002 Dec;77(12):1287-90
12479513
Rev Clin Esp. 1984 Dec 15-31;175(5-6):245-7
6442938
Clin Chem. 1991 Nov;37(11):1917-21
1934465
J Am Acad Dermatol. 1987 Jan;16(1 Pt 1):96-107
3805393
Clin Exp Dermatol. 1988 Jul;13(4):269-70
3246096
J Invest Dermatol. 1972 Mar;58(3):129-32
4259052
Arch Dermatol. 1987 May;123(5):629-32
3579342
Acta Derm Venereol. 1984;64(6):554-6
6084934
Clin Exp Dermatol. 1995 Mar;20(2):149-52
8565252
N Engl J Med. 1990 Aug 23;323(8):508-13
2377176
Dtsch Med Wochenschr. 1981 Jun 5;106(23 ):747-51
7238318
N Engl J Med. 2003 Aug 7;349(6):583-96
12904524
Clin Exp Dermatol. 2000 May;25(3):247-9
10844508