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An indurated plantar plaque with surface nodularity

Nodular amyloidosis, also called primary cutaneous NA, is the rarest form of localized cutaneous AL.[1] NA demonstrate AL amyloid deposition usually limited to the skin, differentiating it from systemic AL.[2] The mean age of onset is 60 years,[3] but NA has been found to affect a broad age range and has no predilection for gender or ethnicity;[4,5] NA tends to localize to the legs, hands, feet, trunk, and genitalia,[2,6] Skin lesions appear as pink to red, deep, indurated, asymptomatic nodules. A waxy appearance and shades of yellow or orange may be noted.[7] Individual lesions range from a few millimeters to several centimeters in diameter, with typical lesions being a centimeter or more at the time of presentation.[8] Lesions can occasionally be bullous, anetodermic, or atrophic.[5] NA is classically asymptomatic with little or no pruritis, but hemorrhage may be noted due to capillary weakness from amyloid deposition.[2] The preoperative differential includes xanthoma, lymphoma cutis, cutaneous sarcoidosis, and keloid.[5]