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CASE REPORT
Curious facial plaque diagnosed as nodular primary localised cutaneous amyloidosis
  1. Dawn Caruana1,
  2. Sarah McCusker1,
  3. Christina Harper2 and
  4. David Bilsland1
  1. 1 Department of Dermatology, Queen Elizabeth University Hospital, Glasgow, UK
  2. 2 Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK
  1. Correspondence to Dr Sarah McCusker, sarah.mccusker1{at}gmail.com

Abstract

Nodular primary localised cutaneous amyloidosis (NPLCA) is the rarest form of cutaneous amyloidosis, with a predilection for facial and acral skin. We present a 63-year-old Caucasian with a 10-year history of an asymptomatic plaque on his left cheek, starting 2 years after being scratched by a cat in the same area. A biopsy showed nodules of eosinophilic material in the deep dermis and subcutaneous fat, with plasma cells in the dermis. Congo red staining displayed apple-green birefringence within the eosinophilic material. Immunohistochemistry for serum amyloid P was positive within the eosinophilic material and immunohistochemistry showed lambda light chain restriction within the plasma cells, consistent with NPLCA. The causal relationship of the cat scratch to NPLCA in our patient remains unclear. While trauma-induced amyloidosis has been recognised in papular and macular amyloid, few case reports indicate an association with nodular amyloidosis.

  • dermatology
  • pathology
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Footnotes

  • Contributors DC and SM had full access to all of the data in the study and take responsibility for the integrity of the data. Acquisition, analysis and interpretation of data; drafting of the manuscript: DC, SM, CH and DB. Critical revision of the manuscript for important intellectual content: DB. Administrative, technical or material support: SM and CH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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