Bullous amyloidosis. A case report

Abstract

A patient with extensive cutaneous amyloidosis had multiple flaccid bullae and waxy plaques on both lower extremities. Trauma appeared to initiate both types of lesions. Ecchymoses readily developed with injury to the affected skin. Histopathologic examination revealed nodular amyloidosis in the lower dermis and perivascular areas along with foci of plasma cells, lymphocytes, and multinucleated giant cells. This picture is seen in primary amyloidosis. An altered immune state is suggested by elevated y-globulins, elevated IgA, and positive anti-nuclear factor.