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Nodular amyloidosis derived from keratinocytes: an unusual type of primary localized cutaneous nodular amyloidosis.
Am J Dermatopathol. 2015 Nov; 37(11):e129-33.AJ

Abstract

Primary, localized cutaneous amyloidosis includes macular, lichen, and nodular (tumefactive) types in which the amyloid deposits are limited to the dermis without systemic involvement. The material in lichen and macular amyloidosis is derived from epidermal keratinocytes [keratinocyte-derived amyloid (AK)], whereas that in nodular amyloidosis is derived from immunoglobulin light-chains amyloid (AL). Primary, localized cutaneous nodular amyloidosis (PLCNA) is a form of primary, localized cutaneous amyloidosis that has been associated with a risk of progression to systemic amyloidosis. We report an unusual case of nodular AK-type amyloid deposited in the dermis of the feet. The patient is a 60-year-old woman with asymptomatic verrucoid-like lesions present around the medial and lateral aspects of the bilateral heels for 1-2 years. A biopsy showed massive deposition of eosinophilic amorphous material in the papillary and reticular dermis. The material stained positive for Congo red with apple-green birefringence on polarized light. It was also positive for pan-cytokeratin and negative for kappa and lambda light-chain immunostains. An extensive workup was negative for systemic involvement. Lipid chromatography tandem mass spectrometry confirmed that the deposition was AK-type amyloid. We believe that this is the first case of PLCNA with AK deposition. This entity should be included in the differential diagnosis of PLCNA so that an extensive systemic workup may be avoided.

Authors+Show Affiliations

Departments of *Pathology, and †Orthopedics, University of Massachusetts Medical School, Worcester, MA.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26485243

Citation

Cornejo, Kristine M., et al. "Nodular Amyloidosis Derived From Keratinocytes: an Unusual Type of Primary Localized Cutaneous Nodular Amyloidosis." The American Journal of Dermatopathology, vol. 37, no. 11, 2015, pp. e129-33.
Cornejo KM, Lagana FJ, Deng A. Nodular amyloidosis derived from keratinocytes: an unusual type of primary localized cutaneous nodular amyloidosis. Am J Dermatopathol. 2015;37(11):e129-33.
Cornejo, K. M., Lagana, F. J., & Deng, A. (2015). Nodular amyloidosis derived from keratinocytes: an unusual type of primary localized cutaneous nodular amyloidosis. The American Journal of Dermatopathology, 37(11), e129-33. https://doi.org/10.1097/DAD.0000000000000307
Cornejo KM, Lagana FJ, Deng A. Nodular Amyloidosis Derived From Keratinocytes: an Unusual Type of Primary Localized Cutaneous Nodular Amyloidosis. Am J Dermatopathol. 2015;37(11):e129-33. PubMed PMID: 26485243.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nodular amyloidosis derived from keratinocytes: an unusual type of primary localized cutaneous nodular amyloidosis. AU - Cornejo,Kristine M, AU - Lagana,Frances J, AU - Deng,April, PY - 2015/10/21/entrez PY - 2015/10/21/pubmed PY - 2016/8/25/medline SP - e129 EP - 33 JF - The American Journal of dermatopathology JO - Am J Dermatopathol VL - 37 IS - 11 N2 - Primary, localized cutaneous amyloidosis includes macular, lichen, and nodular (tumefactive) types in which the amyloid deposits are limited to the dermis without systemic involvement. The material in lichen and macular amyloidosis is derived from epidermal keratinocytes [keratinocyte-derived amyloid (AK)], whereas that in nodular amyloidosis is derived from immunoglobulin light-chains amyloid (AL). Primary, localized cutaneous nodular amyloidosis (PLCNA) is a form of primary, localized cutaneous amyloidosis that has been associated with a risk of progression to systemic amyloidosis. We report an unusual case of nodular AK-type amyloid deposited in the dermis of the feet. The patient is a 60-year-old woman with asymptomatic verrucoid-like lesions present around the medial and lateral aspects of the bilateral heels for 1-2 years. A biopsy showed massive deposition of eosinophilic amorphous material in the papillary and reticular dermis. The material stained positive for Congo red with apple-green birefringence on polarized light. It was also positive for pan-cytokeratin and negative for kappa and lambda light-chain immunostains. An extensive workup was negative for systemic involvement. Lipid chromatography tandem mass spectrometry confirmed that the deposition was AK-type amyloid. We believe that this is the first case of PLCNA with AK deposition. This entity should be included in the differential diagnosis of PLCNA so that an extensive systemic workup may be avoided. SN - 1533-0311 UR - https://www.unboundmedicine.com/medline/citation/26485243/Nodular_amyloidosis_derived_from_keratinocytes:_an_unusual_type_of_primary_localized_cutaneous_nodular_amyloidosis_ L2 - http://dx.doi.org/10.1097/DAD.0000000000000307 DB - PRIME DP - Unbound Medicine ER -