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Primary amyloidosis-induced nail dystrophy.

Abstract
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.
AuthorsWilliam Tausend, Megan Neill, Brent Kelly
JournalDermatology online journal (Dermatol Online J) Vol. 20 Issue 1 Pg. 21247 (Jan 15 2014) ISSN: 1087-2108 [Electronic] United States
PMID24456950 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Immunoglobulin kappa-Chains
  • Paraproteins
  • Bence Jones Protein
Topics
  • Amyloidosis (etiology)
  • Bacteremia (complications)
  • Bence Jones Protein (urine)
  • Biopsy
  • Diagnostic Errors
  • Humans
  • Immunoglobulin kappa-Chains (blood, urine)
  • Male
  • Methicillin-Resistant Staphylococcus aureus (isolation & purification)
  • Middle Aged
  • Nails, Malformed (etiology)
  • Paraproteinemias (complications, diagnosis)
  • Paraproteins (analysis)
  • Staphylococcal Infections (complications)
  • Warts (diagnosis)

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