Primary Systemic Amyloidosis and the Dermatologist

Primary systemic amyloidosis is a rare disorder characterized by multisystemic homogenous hyaline amyloid material. We report a case of 68 years old male presented with generalized weakness, fatigue, anorexia and impaired taste sensation. Muco-cutaneous lesions like, macroglossia with bullous haemorrhagic lesions, peri-orbital purpura, and nail changes were present. He had no cardiomegaly, hepatomegaly, splenomegaly or renal involvement. His skiagram chest showed minimal left sided pleural effusion which had no pus cells despite high protein content. The diagnosis was established on the basis of classical cutaneous lesions. Diagnosis was confirmed by tongue biopsy using Haematoxylin and Eosin staining and crystal violet staining. Polarized microscopy was not done because of unavailability. We report this case because of the sheer rare presentation and diagnosis is considered in dermatologist’s differentials. This case report suggests that skin lesions may provide a clue for an early diagnosis of systemic amyloidosis, which lengthens the survival period of the patient.