A 73-year-old female Japanese patient presented with 15 variously sized (0.5-3.0 cm diameter), raised, waxy, reddish-brown, asymptomatic nodules on her lower extremities in addition to one on her waist (Picture 1) which appeared several years prior to presentation. A histological analysis revealed the homogeneous deposition of eosinophilic amorphous material (Picture 2) which was positive for Congo-red stain (Picture 3) and the infiltration of plasma cells (Picture 4). The laboratory findings demonstrated anti-SS-A ≥240 IU/mL and SAA 7.9 μg/mL. No immunoglobulin light chain restriction was observed either histologically or serologically. After myeloma-associated systemic amyloidosis was ruled out by a systemic investigation in addition to serum protein electrophoresis, light chain amyloidosis (AL)-type localized cutaneous nodular amyloidosis (LCNA) was thus diagnosed. Despite no sicca symptoms, Sjögren's syndrome was diagnosed based on the positive results of anti-SS-A antibody and a salivary gland biopsy specimen. LCNA associated with Sjögren's syndrome has been previously reported (1) and it can occasionally be identified by the presence of multiple nodules (2).
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The authors state that they have no Conflict of Interest (COI).
References
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