Cases for Diagnosis
Plaque on the Nose
Placa en la nariz
B. de Unamuno-Bustos
, R. Ballester-Sánchez, V. Alegre de Miquel
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Servicio de Dermatología, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
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Ballester-Sánchez, V. Alegre de Miquel" "autores" => array:3 [ 0 => array:4 [ "nombre" => "B." "apellidos" => "de Unamuno-Bustos" "email" => array:1 [ 0 => "blancaunamuno@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Ballester-Sánchez" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Alegre de Miquel" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Consorcio Hospital General Universitario de Valencia, Valencia, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding Author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Placa en la nariz" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 404 "Ancho" => 575 "Tamanyo" => 51758 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Medical History</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 45-year-old man with no relevant past history presented with a lesion of 2 years’ duration on the left wing of the nose. He reported no itching, pain, or any other symptoms.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">Examination showed a poorly circumscribed, firm erythematous plaque with a diameter of approximately 3<span class="elsevierStyleHsp" style=""></span>cm on the left wing of the nose and cheek. There were also several nodules with a hard consistency and a slight yellowish color on the plaque (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Histopathology</span><p id="par0015" class="elsevierStylePara elsevierViewall">Histology of the lesion showed epidermal atrophy and deposits of an amorphous eosinophilic material throughout the papillary and reticular dermis. Next to this material was a mild plasma cell infiltrate (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Congo red staining showed bright apple-green birefringence under polarized light (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>A), and the deposited material exhibited fluorescence with thioflavin T staining under fluorescence microscopy (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>B).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Additional Tests</span><p id="par0020" class="elsevierStylePara elsevierViewall">Gene rearrangement analysis of the skin biopsy specimen showed B-cell clonality. Laboratory tests, which included a complete blood count, kidney and liver function tests, a protein profile and immunoglobulin tests, showed no abnormalities.</p><p id="par0065" class="elsevierStylePara elsevierViewall">What Is Your Diagnosis?</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Diagnosis</span><p id="par0025" class="elsevierStylePara elsevierViewall">Primary nodular localized cutaneous amyloidosis (PNLCA).</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Course</span><p id="par0030" class="elsevierStylePara elsevierViewall">Twelve months later, the lesions are still stable and the patient attends periodic follow-up visits.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Comment</span><p id="par0035" class="elsevierStylePara elsevierViewall">Amyloidosis refers to a spectrum of disorders characterized by amyloid deposits in the tissues. In primary cutaneous amyloidosis, the deposited material is confined to the skin, without involvement of any other organs.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> A distinction is made between macular amyloidosis, lichen amyloidosis, and the less common form, nodular amyloidosis.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In macular and lichenoid amyloidosis, the amyloid deposits, which are typically found in the papillary dermis, are derived from the degeneration of keratin filaments.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In PNLCA, the deposited material is observed in both the papillary and the reticular dermis, and may extend as far as the subcutaneous tissue. Because the amyloid proteins deposited in PNLCA are produced by plasma cells, some authors have suggested that the condition should be considered an extramedullary plasmacytoma with local amyloid deposition. Gene rearrangement studies have demonstrated plasma-cell but not bone marrow–cell clonality.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The clinical presentation consists of firm erythematous or yellowish nodules or plaques with a shiny surface. The lesions are usually solitary, but multiple, disseminated lesions may occasionally be observed.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> PNLCA tends to affect acral sites and the most frequently involved locations are the lower limbs, the nose, and the periauricular areas.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The condition has been associated with systemic diseases such as Sjögren syndrome,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> diabetes mellitus, and CREST syndrome (Calcinosis, Raynaud phenomenon, Esophageal dysmotility, Sclerodactyly, and Telangiectasia).</p><p id="par0045" class="elsevierStylePara elsevierViewall">Histology findings include epidermal atrophy and deposits of amorphous eosinophilic material occupying the dermis and the hypodermis. A perivascular plasma cell infiltrate is also a characteristic feature</p><p id="par0050" class="elsevierStylePara elsevierViewall">PNLCA generally runs an indolent course, but close follow-up is recommended as there have been reports of progression to systemic amyloidosis.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of Interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Medical History" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Physical Examination" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Histopathology" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Additional Tests" ] 4 => array:2 [ "identificador" => "sec0030" "titulo" => "Diagnosis" ] 5 => array:2 [ "identificador" => "sec0035" "titulo" => "Course" ] 6 => array:2 [ "identificador" => "sec0040" "titulo" => "Comment" ] 7 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflicts of Interest" ] 8 => array:2 [ "identificador" => "xack77691" "titulo" => "Acknowledgments" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: de Unamuno-Bustos B, Ballester-Sánchez R, Alegre de Miquel V. Placa en la nariz. Actas Dermosifiliogr. 2014;105:305–306.</p>" ] ] "multimedia" => array:3 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 404 "Ancho" => 575 "Tamanyo" => 51758 ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 406 "Ancho" => 550 "Tamanyo" => 100204 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin-eosin staining, original magnification x40.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 389 "Ancho" => 1050 "Tamanyo" => 129548 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Congo red, original magnification ×100. B, Thioflavin T, original magnification ×100.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Amyloid and amyloidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.M. Breathnach" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "1988" "volumen" => "18" "paginaInicial" => "1" "paginaFinal" => "16" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3279077" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nodular localized primary cutaneous amyloidosis: A long-term follow-up study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Wollons" 1 => "M.M. Black" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2001" "volumen" => "145" "paginaInicial" => "105" "paginaFinal" => "109" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11453916" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Amiloidosis cutánea primaria localizada nodular con patrón diseminado" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Feito-Rodríguez" 1 => "J. García-Macarrón" 2 => "B. Pagán-Muñoz" 3 => "A. Mariño-Enríquez" 4 => "Y. Vidaurrázaga-Díaz" 5 => "C. Arcaya" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2008" "volumen" => "99" "paginaInicial" => "648" "paginaFinal" => "652" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19080897" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Amiloidosis nodular primaria cutánea localizada en un paciente con paraproteinemia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Villar" 1 => "M. Burgués" 2 => "J.L. Rodríguez-Peralto" 3 => "R. Rivera" 4 => "F. Vanaclocha" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2011.05.017" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2012" "volumen" => "103" "paginaInicial" => "161" "paginaFinal" => "162" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21885025" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A rare case of primary cutaneous nodular amyloidosis of the face" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Koh" 1 => "C.Y. Kwok" 2 => "H.W. Tan" 3 => "J.F. Mancer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2007.02541.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2008" "volumen" => "22" "paginaInicial" => "1011" "paginaFinal" => "1012" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18201173" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Amiloidosis cutánea nodular primaria asociada a síndrome de Sjögren: presentación de un caso" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Chavarría" 1 => "M. González-Carrascosa" 2 => "J.M. Hernanz" 3 => "M. Lecona" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2005" "volumen" => "96" "paginaInicial" => "446" "paginaFinal" => "449" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16476272" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack77691" "titulo" => "Acknowledgments" "texto" => "<p id="par0060" class="elsevierStylePara elsevierViewall">We thank Dr Adrian Lloret for his help.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010500000003/v1_201404030048/S1578219014000559/v1_201404030048/en/main.assets" "Apartado" => array:4 [ "identificador" => "6154" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case for Diagnosis" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010500000003/v1_201404030048/S1578219014000559/v1_201404030048/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014000559?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 10 | 14 | 24 |
| 2024 Octubre | 77 | 48 | 125 |
| 2024 Septiembre | 92 | 23 | 115 |
| 2024 Agosto | 128 | 63 | 191 |
| 2024 Julio | 124 | 30 | 154 |
| 2024 Junio | 121 | 38 | 159 |
| 2024 Mayo | 105 | 32 | 137 |
| 2024 Abril | 100 | 20 | 120 |
| 2024 Marzo | 95 | 24 | 119 |
| 2024 Febrero | 77 | 36 | 113 |
| 2024 Enero | 86 | 31 | 117 |
| 2023 Diciembre | 75 | 17 | 92 |
| 2023 Noviembre | 67 | 26 | 93 |
| 2023 Octubre | 61 | 15 | 76 |
| 2023 Septiembre | 69 | 31 | 100 |
| 2023 Agosto | 41 | 19 | 60 |
| 2023 Julio | 66 | 30 | 96 |
| 2023 Junio | 66 | 20 | 86 |
| 2023 Mayo | 65 | 21 | 86 |
| 2023 Abril | 63 | 20 | 83 |
| 2023 Marzo | 62 | 22 | 84 |
| 2023 Febrero | 93 | 25 | 118 |
| 2023 Enero | 45 | 23 | 68 |
| 2022 Diciembre | 72 | 42 | 114 |
| 2022 Noviembre | 39 | 22 | 61 |
| 2022 Octubre | 26 | 27 | 53 |
| 2022 Septiembre | 27 | 36 | 63 |
| 2022 Agosto | 27 | 43 | 70 |
| 2022 Julio | 29 | 36 | 65 |
| 2022 Junio | 27 | 24 | 51 |
| 2022 Mayo | 49 | 44 | 93 |
| 2022 Abril | 70 | 36 | 106 |
| 2022 Marzo | 69 | 42 | 111 |
| 2022 Febrero | 42 | 27 | 69 |
| 2022 Enero | 57 | 33 | 90 |
| 2021 Diciembre | 47 | 38 | 85 |
| 2021 Noviembre | 59 | 49 | 108 |
| 2021 Octubre | 42 | 51 | 93 |
| 2021 Septiembre | 37 | 38 | 75 |
| 2021 Agosto | 41 | 30 | 71 |
| 2021 Julio | 45 | 23 | 68 |
| 2021 Junio | 31 | 27 | 58 |
| 2021 Mayo | 34 | 26 | 60 |
| 2021 Abril | 85 | 61 | 146 |
| 2021 Marzo | 53 | 13 | 66 |
| 2021 Febrero | 71 | 19 | 90 |
| 2021 Enero | 44 | 24 | 68 |
| 2020 Diciembre | 31 | 11 | 42 |
| 2020 Noviembre | 19 | 7 | 26 |
| 2020 Octubre | 27 | 8 | 35 |
| 2020 Septiembre | 29 | 11 | 40 |
| 2020 Agosto | 38 | 12 | 50 |
| 2020 Julio | 18 | 7 | 25 |
| 2020 Junio | 31 | 22 | 53 |
| 2020 Mayo | 17 | 13 | 30 |
| 2020 Abril | 25 | 11 | 36 |
| 2020 Marzo | 32 | 11 | 43 |
| 2020 Febrero | 3 | 1 | 4 |
| 2020 Enero | 0 | 1 | 1 |
| 2019 Diciembre | 2 | 4 | 6 |
| 2019 Noviembre | 0 | 1 | 1 |
| 2019 Septiembre | 4 | 1 | 5 |
| 2019 Julio | 0 | 7 | 7 |
| 2019 Junio | 2 | 11 | 13 |
| 2019 Mayo | 0 | 17 | 17 |
| 2019 Abril | 0 | 2 | 2 |
| 2019 Marzo | 2 | 5 | 7 |
| 2019 Enero | 1 | 0 | 1 |
| 2018 Octubre | 2 | 0 | 2 |
| 2018 Septiembre | 4 | 0 | 4 |
| 2018 Febrero | 29 | 2 | 31 |
| 2018 Enero | 62 | 3 | 65 |
| 2017 Diciembre | 50 | 8 | 58 |
| 2017 Noviembre | 47 | 5 | 52 |
| 2017 Octubre | 41 | 4 | 45 |
| 2017 Septiembre | 50 | 3 | 53 |
| 2017 Agosto | 56 | 4 | 60 |
| 2017 Julio | 41 | 7 | 48 |
| 2017 Junio | 65 | 9 | 74 |
| 2017 Mayo | 62 | 2 | 64 |
| 2017 Abril | 53 | 5 | 58 |
| 2017 Marzo | 36 | 17 | 53 |
| 2017 Febrero | 37 | 5 | 42 |
| 2017 Enero | 24 | 9 | 33 |
| 2016 Diciembre | 40 | 7 | 47 |
| 2016 Noviembre | 47 | 6 | 53 |
| 2016 Octubre | 32 | 7 | 39 |
| 2016 Septiembre | 40 | 10 | 50 |
| 2016 Agosto | 53 | 8 | 61 |
| 2016 Julio | 42 | 6 | 48 |
| 2016 Junio | 10 | 4 | 14 |
| 2016 Mayo | 6 | 4 | 10 |
| 2016 Abril | 4 | 4 | 8 |
| 2016 Marzo | 4 | 4 | 8 |
| 2016 Febrero | 8 | 8 | 16 |
| 2016 Enero | 8 | 9 | 17 |
| 2015 Diciembre | 5 | 7 | 12 |
| 2015 Noviembre | 5 | 7 | 12 |
| 2015 Octubre | 5 | 5 | 10 |
| 2015 Septiembre | 2 | 0 | 2 |
| 2015 Agosto | 9 | 3 | 12 |
| 2015 Julio | 41 | 3 | 44 |
| 2015 Junio | 34 | 4 | 38 |
| 2015 Mayo | 44 | 7 | 51 |
| 2015 Abril | 28 | 2 | 30 |
| 2015 Marzo | 20 | 2 | 22 |
| 2015 Febrero | 28 | 1 | 29 |
| 2015 Enero | 42 | 5 | 47 |
| 2014 Diciembre | 38 | 5 | 43 |
| 2014 Noviembre | 26 | 8 | 34 |
| 2014 Octubre | 28 | 8 | 36 |
| 2014 Septiembre | 34 | 6 | 40 |
| 2014 Agosto | 18 | 4 | 22 |
| 2014 Julio | 15 | 8 | 23 |
| 2014 Junio | 24 | 8 | 32 |
| 2014 Mayo | 25 | 8 | 33 |
| 2014 Abril | 35 | 7 | 42 |
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