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Primary Systemic Amyloidosis Causing Diffuse Alopecia by Telogen Arrest

Primary Systemic Amyloidosis Causing Diffuse Alopecia by Telogen Arrest Abstract To the Editor.— The primary and myeloma-associated forms of systemic amyloidosis are frequently associated with cutaneous manifestations, ie, purpuric lesions due to amyloid in vessel walls, or smooth waxy papules, plaques, and nodules due to dermal amyloid deposits.1,2 Alopecia is less common but may occur as part of the clinical spectrum of established disease or, rarely, as a sign of occult amyloidosis.3,4 We report a patient whose diffuse alopecia led to the diagnosis of primary systemic amyloidosis. The histopathologic changes in serial biopsy specimens demonstrate that amyloid inhibits anagen restoration of hair follicles, perhaps by vascular impairment. Report of a Case.— A 59-year-old, asymptomatic, white woman presented with a 4-month history of diffuse scalp alopecia (Fig 1), generalized thinning of body hair, and easy bruisability. Physical examination revealed a greater than 50% reduction in scalp hair density, positive hair pulls, increased hair part widths, and microscopically normal hair References 1. Brownstein MH, Helwig EB. The cutaneous amyloidoses II: systemic forms . Arch Dermatol. 1970;102:20-28.Crossref 2. Goltz RW. Systematized amyloidosis: a review of skin and mucous membrane lesions and a report of two cases . Medicine. 1952;31:381-409.Crossref 3. Wheeler GE, Barrows GH. Alopecia universalis: a manifestation of occult amyloidosis and multiple myeloma . Arch Dermatol. 1981;117:815-816.Crossref 4. Blanc D, Kienzler JL, Faivre R, et al. Amylose systematisée primitive avec alopecie et onychodystrophie generalisées . Ann Dermatol Venereol (Paris) . 1982;109:877-880. 5. Breathnach SM. Amyloid and amyloidosis . J Am Acad Dermatol. 1988;18:1-16.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Primary Systemic Amyloidosis Causing Diffuse Alopecia by Telogen Arrest

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1991.01680060143030
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.— The primary and myeloma-associated forms of systemic amyloidosis are frequently associated with cutaneous manifestations, ie, purpuric lesions due to amyloid in vessel walls, or smooth waxy papules, plaques, and nodules due to dermal amyloid deposits.1,2 Alopecia is less common but may occur as part of the clinical spectrum of established disease or, rarely, as a sign of occult amyloidosis.3,4 We report a patient whose diffuse alopecia led to the diagnosis of primary systemic amyloidosis. The histopathologic changes in serial biopsy specimens demonstrate that amyloid inhibits anagen restoration of hair follicles, perhaps by vascular impairment. Report of a Case.— A 59-year-old, asymptomatic, white woman presented with a 4-month history of diffuse scalp alopecia (Fig 1), generalized thinning of body hair, and easy bruisability. Physical examination revealed a greater than 50% reduction in scalp hair density, positive hair pulls, increased hair part widths, and microscopically normal hair References 1. Brownstein MH, Helwig EB. The cutaneous amyloidoses II: systemic forms . Arch Dermatol. 1970;102:20-28.Crossref 2. Goltz RW. Systematized amyloidosis: a review of skin and mucous membrane lesions and a report of two cases . Medicine. 1952;31:381-409.Crossref 3. Wheeler GE, Barrows GH. Alopecia universalis: a manifestation of occult amyloidosis and multiple myeloma . Arch Dermatol. 1981;117:815-816.Crossref 4. Blanc D, Kienzler JL, Faivre R, et al. Amylose systematisée primitive avec alopecie et onychodystrophie generalisées . Ann Dermatol Venereol (Paris) . 1982;109:877-880. 5. Breathnach SM. Amyloid and amyloidosis . J Am Acad Dermatol. 1988;18:1-16.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Jul 1, 1991

References