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May 2010

Nodules on the Feet—Diagnosis

Author Affiliations
 

MARY S.STONEMDSOONBAHRAMIMDCARRIE ANN R.CUSACKMDSENAIT W.DYSONMDMOLLY A.HINSHAWMDVINCENTLIUMD

Arch Dermatol. 2010;146(5):557-562. doi:10.1001/archdermatol.2010.76-b

Hematoxylin-eosin–stained sections of the specimen revealed nodular dermal deposits of amorphous, eosinophilic material with accentuation around blood vessels and adnexal structures. In addition, plasma cells were conspicuous at the margins and within the amorphous material. Congo red–stained sections highlighted the deposits that demonstrated apple green birefringence on polarized light viewing. Immunohistochemical staining for λ and κ immunoglobulin light chains demonstrated κ immunoglobulin light chain restriction. Findings from further investigations to exclude systemic involvement were negative, including results for SS-A and SS-B antibodies and serum and urine protein electrophoresis. Treatment options were provided to the patient, who declined treatment for the asymptomatic lesions at this time.

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