Systemic amyloidosis, purpura differential diagnosis

  • Dermatologic features
    – Purpura from capillary fragility – periorbital area is classical
    – Waxy papules or nodules, typically on eyelids (resembling xanthelasma), neck and anogenital areas
  • Macroglossia
  • Can affect heart, lung, liver, kidneys
  • A few types, more common ones are these two types:
    – AA type: from systemic inflammatory disorder
    – AL type: multiple myeloma (presence of immunoglobulin light chains or paraprotein)

Purpura differential diagnosis

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Ellen K Roh et al. Case 2-2016: An 84-Year-Old Woman with Chest Pain, Dyspnea, and a Rash. N Engl J Med 2016;374:264-74.


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