title: Primary systemic amyloidosis presenting as extensive cutaneous ulceration.
abstract: BACKGROUND
  We report a case of primary systemic amyloidosis in a 78-year-old Caucasian woman presented as a nonhealing ulcer on the right thigh for 3 months. Histopathology of the skin revealed widely thickened walls of middermal and subcutaneous vessels from deposition of amorphous eosinophilic material that stained positively with Congo red and crystal violet.
  
  
  OBJECTIVE
  This case represents a very unusual presentation of primary systemic amyloidosis, one in which the cutaneous manifestations provided the first signs of a devastatingly widespread multiorgan infiltration of amyloid protein.
  
  
  CONCLUSIONS
  This presentation of the disease may signify an advanced stage with a grave prognosis as our patient passed away 3 months after development of the cutaneous ulceration.
authors.affiliation: Department of Dermatology, McGill University Health Centre, Montreal, QC, Canada. malhaddab@yahoo.ca
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alhaddab
authors.forename: Herbert
authors.initials: H
authors.lastname: Srolovitz
authors.forename: Nathan
authors.initials: N
authors.lastname: Rosen
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D001706:Biopsy; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D012883:Skin Ulcer / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D013848:Thigh