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December 1981

Alopecia Universalis: A Manifestation of Occult Amyloidosis and Multiple Myeloma

Author Affiliations

From the Departments of Medicine (Dr Wheeler) and Pathology (Dr Barrows), University of Louisville Health Sciences Center.

Arch Dermatol. 1981;117(12):815-816. doi:10.1001/archderm.1981.01650120061028

Cutaneous involvement is a frequent clinical and pathologic finding in amyloidosis associated with plasma cell dyscrasias.1,2 Common clinical features include purpura, papules, nodules, plaques, and scleroderma-like changes.2-5 We describe herein a patient in whom generalized hair loss and anonychia were early prominent manifestations of unsuspected amyloidosis and multiple myeloma.

Report of a Case  A 65-year-old woman was referred to us for examination and treatment of congestive heart failure in October 1980. Orthopnea, paroxysmal nocturnal dyspnea, and pedal edema had initially developed in 1977 and had responded to therapy with digoxin and hydrochlorothiazide until one month earlier. Coincidentally with the onset of heart disease, the patient had noticed brittleness of her fingernails and the gradual loss of all body hair. She had worn a wig for the past 18 months. Her only other symptoms included a 5.5-kg weight loss and dysarthria of three months' duration.Physical examination at the

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