Rubinow A, Cohen A S
Ann Intern Med. 1978 Jun;88(6):781-5. doi: 10.7326/0003-4819-88-6-781.
A punch or excisional biopsy of the skin was done in 50 patients with generalized amyloidosis: In 46, clinically normal skin, usually the forearm, was biopsied and in four, only cutaneous lesions. Amyloid was seen in the skin of 21 of 38 patients with primary and multiple myeloma-associated amyloidosis. Sixteen of 34 biopsies from clinically uninvolved skin were positive. Five of 12 patients with secondary amyloidosis had amyloid deposits in clinically normal skin. Overall, amyloidosis was definitively diagnosed on skin biopsy examination in 26 patients. A punch biopsy of clinically involved or uninvolved skin is an innocuous, simple procedure with a high diagnostic yield and can be done in an office setting.
对50例全身性淀粉样变性患者进行了皮肤打孔活检或切除活检：46例患者取临床上正常的皮肤（通常是前臂皮肤）进行活检，4例仅对皮肤病变部位进行活检。在38例原发性和多发性骨髓瘤相关性淀粉样变性患者中，21例的皮肤中发现了淀粉样物质。34例取自临床上未受累皮肤的活检标本中，16例呈阳性。12例继发性淀粉样变性患者中有5例在临床上正常的皮肤中有淀粉样物质沉积。总体而言，通过皮肤活检检查确诊了26例淀粉样变性患者。对临床上受累或未受累皮肤进行打孔活检是一种无害、简单的操作，诊断率高，可在门诊进行。
