Primary amyloidosis-induced nail dystrophy.
Primary amyloidosis is caused by a monoclonal proliferation of plasma cells and is capable of producing cutaneous lesions. A 56-year-old male was admitted to the hospital for evaluation of chronic back pain and acute lower extremity weakness. On examination, he was noted to have subungual verrucous plaques with overlying nail dystrophy on his bilateral thumbs. A biopsy of one subungual lesion showed a deposition of amorphous material in the dermis that stained with Congo red and crystal violet. These cutaneous lesions ultimately led to the diagnosis of plasma cell dyscrasia and primary amyloidosis. Based on the literature search, primary amyloidosis presenting with this degree of subungual thickening and overlying nail dystrophy has not been previously reported.
University of Texas Medical Branch.
William
W
Tausend
Megan
M
Neill
Brent
B
Kelly
D000686:Amyloidosis / Q000209:etiology*; D016470:Bacteremia / Q000150:complications; D001536:Bence Jones Protein / Q000652:urine; D001706:Biopsy; D003951:Diagnostic Errors; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000097:blood / Q000652:urine; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D009264:Nails, Malformed / Q000209:etiology*; D010265:Paraproteinemias / Q000150:complications* / Q000175:diagnosis; D010266:Paraproteins / Q000032:analysis; D013203:Staphylococcal Infections / Q000150:complications; D014860:Warts / Q000175:diagnosis
D007145:Immunoglobulin kappa-Chains; D010266:Paraproteins; D001536:Bence Jones Protein