To the Editor.—
Different skin lesions have been described in primary amyloidosis, including papules, nodules, bullae, plaques, and hemorrhages, which are usually petechial but occasionally more extensive.1,2 Purpuric lesions seen in systemic amyloidosis often involve the face and neck, particularly the upper eyelids. The following is a case with striking periorbital purpura that developed after percutaneous renal biopsy.
Report of a Case.—
A 75-year-old man was referred with complaints of dysphagia, fatigue, weakness, inappetentia, and a weight loss of 15 kg in a period of four months. Physical examination results were unremarkable except for pitting ankle edema, muscle wasting, and orthostatic blood pressure drop (from 110/70 to 95/60 mm Hg). The electrophysiological studies (motor nerve conduction velocity) showed peripheral neuropathy. Routine urinalysis disclosed 4± protein with hyaline and granular casts. The 24-hour urine protein level was 2.1 g. The serum protein level was 5.2 g/dL; albumin, 2.8 g/dL; creatinine,