Fernandes Carolina, Éthier Vincent, Marouan Sofia, Chababi-Atallah Myrna, Veilleux Mylène
University of Sherbrooke, Sherbrooke, QC, Canada.
SAGE Open Med Case Rep. 2019 Nov 29;7:2050313X19890755. doi: 10.1177/2050313X19890755. eCollection 2019.
The main objective of this article is to present and discuss a case of localized ulcerative nodular amyloidosis with deep involvement clinically manifesting as ulcerative panniculitis and discuss its impact on the choice of treatment.
We present a 73-year-old woman with a history of painful ulcerated nodules on the inferior limbs. Microscopy confirmed amyloid deposits deep in the dermis and subcutaneous fat. No systemic involvement was found. Considering that skin-directed treatments often are not able to reach subcutaneous fat or were contraindicated because of the ulcers, she was successfully treated with cyclophosphamide and prednisone.
Localized ulcerative nodular amyloidosis with deep involvement is a rare clinical presentation that can present as ulcerative panniculitis. Such a clinical manifestation might be misleading. Systemic treatment might be necessary to control symptoms when conventional skin-directed therapies are contraindicated.
本文的主要目的是呈现并讨论一例局部溃疡性结节性淀粉样变,其深部受累临床上表现为溃疡性脂膜炎,并探讨其对治疗选择的影响。
我们报告一名73岁女性,有下肢疼痛性溃疡结节病史。显微镜检查证实真皮和皮下脂肪深部有淀粉样沉积。未发现系统性受累。考虑到针对皮肤的治疗通常无法到达皮下脂肪或因溃疡而禁忌,她接受环磷酰胺和泼尼松治疗成功。
深部受累的局部溃疡性结节性淀粉样变是一种罕见的临床表现,可表现为溃疡性脂膜炎。这种临床表现可能会产生误导。当传统的针对皮肤的治疗禁忌时,可能需要全身治疗来控制症状。