Myeloma‐associated AL amyloidosis presenting with nail dystrophy and scleroderma‐like skin changes

An unusual presentation of systemic AL amyloidosis: bullae, milia and nail dystrophy

Clinical and Experimental Dermatology ◽

10.1111/j.1365-2230.2012.04341.x ◽

2012 ◽

Vol 37 (7) ◽

pp. 788-790 ◽

Cited By ~ 3

Author(s):

A. E. Pink ◽

C. M. Stefanato ◽

S. M. Breathnach

Keyword(s):

Unusual Presentation ◽

Al Amyloidosis ◽

Nail Dystrophy

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Acquired Ulcero-Mutilating Bilateral Acro-Osteopathy (Bureau-Barrière Syndrome)

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2017.134 ◽

2017 ◽

Vol 5 (4) ◽

pp. 558-560

Author(s):

Georgi Tchernev ◽

Hristo Mangarov ◽

Ilia Lozev ◽

Ivan Pidakev ◽

Torello Lotti ◽

...

Keyword(s):

Alcohol Consumption ◽

Lower Limb ◽

Alcohol Intake ◽

Clinical Presentation ◽

Interdisciplinary Approach ◽

Bone Lesions ◽

Nail Dystrophy ◽

Skin Changes ◽

Excessive Alcohol ◽

Excessive Alcohol Intake

We present a 35-year-old male patient with Bureau-Barrière syndrome. Bureau-Barrière syndrome is an ulcero-mutilating acropathy almost invariably associated with excessive alcohol intake. It presents with a triad of trophic skin changes with recurrent ulcerations, bone lesions and nerve damage. The clinical presentation includes chronic painless plantar ulcerations with periulcerous hyperkeratosis, hyperhidrosis, livedoid skin colour, nail dystrophy, widening and infiltration of the toes and common interdigital mycoses. Other non-specific skin changes related to the alcohol consumption are commonly observed as well. The condition affects mainly middle-aged men suffering from alcoholism. Often a bilateral location at the lower limb of male alcoholics has been described, as in our patient. Successful treatment of the Bureau-Barrière syndrome requires an interdisciplinary approach. Cessation of alcohol intake and smoking is of paramount importance.

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Nail Biopsy in the Diagnosis of Systemic Amyloidosis

SKIN The Journal of Cutaneous Medicine ◽

10.25251/skin.2.4.9 ◽

2018 ◽

Vol 2 (4) ◽

pp. 252-255

Author(s):

Cristopher C Briscoe ◽

Zachary P Nahmias ◽

Ilana S Rosman ◽

Milan J Anadkat

Keyword(s):

Monoclonal Gammopathy ◽

Conventional Treatment ◽

Systemic Amyloidosis ◽

Al Amyloidosis ◽

Nail Dystrophy ◽

Hematopoietic Stem ◽

Nail Changes ◽

Unknown Significance ◽

History Of ◽

Low Threshold

A 60-year-old woman with a 13-year history of monoclonal gammopathy of unknown significance (MGUS) presented with worsening nail dystrophy. Prior workup for systemic amyloidosis had been unrevealing, and no other signs of cutaneous disease were present. Nail biopsy was consistent with amyloid deposition, and the patient subsequently underwent autologous hematopoietic stem cell transplantation for AL amyloidosis. In light of the growing literature regarding nail changes as a presenting sign of systemic amyloidosis and the promising utility of nail biopsy, we suggest a low threshold for biopsy in appropriate patients when nail changes characteristic of amyloidosis are refractory to conventional treatment.

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