TOC and Sample Chapters - McGraw-Hill Professional
TOC and Sample Chapters - McGraw-Hill Professional
TOC and Sample Chapters - McGraw-Hill Professional
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Section 14 The Skin in Immune, Autoimmune, <strong>and</strong> Rheumatic Disorders 305<br />
Localized Cutaneous Amyloidosis ICD-10: E85.810/E85.430<br />
■ Three varieties of localized amyloidosis that are<br />
unrelated to the systemic amyloidoses.<br />
■ Nodular amyloidosis: single or multiple, smooth,<br />
nodular lesions with or without purpura on limbs,<br />
face, or trunk (Fig. 14-4A).<br />
■ Lichenoid amyloidosis: discrete, very pruritic,<br />
brownish-red papules on the legs (Fig. 14-4B).<br />
■ Macular amyloidosis: pruritic, gray-brown,<br />
reticulated macular lesions occurring principally on<br />
A B<br />
◧ ◐<br />
the upper back (Fig. 14-5); the lesions often have<br />
a distinctive “ripple” pattern.<br />
■ In lichenoid <strong>and</strong> macular amyloidosis, the amyloid<br />
fibrils in skin are keratin derived. Although these<br />
three localized forms of amyloidosis are confined<br />
to the skin <strong>and</strong> unrelated to systemic disease, the<br />
skin lesions of nodular amyloidosis are identical<br />
to those that occur in AL, in which amyloid<br />
fibrils derive from immunoglobulin light chain<br />
fragments.<br />
Figure 14-4. Localized cutaneous amyloidosis (A) Nodular. Two plaque-like nodules, waxy, yellowish-orange with<br />
hemorrhage. (B) Lichenoid amyloidosis. Grouped confluent scaly papules of livid, violaceous color. This is a purely cutaneous<br />
disease.
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