Primary Localized Cutaneous Nodular Amyloidosis Presenting as Milia: An Unusual Clinical Manifestation

Abstract

Primary localized cutaneous nodular amyloidosis (PLCNA) is rare and clinically noncharacteristic, presenting mostly as plaque-like lesions. We report a case of a progressively larger erythematous plaque following a contusion of the skin on the right zygomatic area, which was strangely covered with recurrent scattered 2 mm whiteish blisters to the extent that it was misdiagnosed as a herpesvirus infection several times over a decade. Pathology and special staining diagnosed nodular amyloidosis with milia.

Keywords: local trauma; milia; plaque; primary localized cutaneous nodular amyloidosis.

Figure 1

Orange‒yellow plaque with overlying scattered 2 mm whiteish blisters on the right zygomatic area.

Figure 2

Three pathological images of nodular amyloidosis. (A) Deposition of acellular amorphous eosinophilic materials over the entire dermis and subcutis (H&E, ×200). (B) The amyloid deposits were positive for Congo red staining, and keratinous cysts were found in the superficial dermis. The arrows indicate the sites of amyloid deposits.(Congo red staining, ×200) (C) The amyloid deposits were positive for crystal violet staining, and keratinous cysts were found in the superficial dermis. The arrows indicate the sites of amyloid deposits. (Crystal violet staining, ×200).