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Photographs showing (a) enlarged tongue with (b) teeth marks over the lateral margin and (c, d) multiple, papular lesions over lower chest wall
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On evaluation, she had macroglossia [Figure 1(a, b)]. There were multiple, non-itchy, papular lesions in lower eyelids and lower chest wall bilaterally [Figure 1(c, d)].
Microphotograph showing pink eosinophilic homogenous material in the dermis, H&E X 20
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A biopsy from skin lesions over chest wall showed pink acellular eosinophilic homogenous material in the dermis on haemotoxylin & eosin staining (Figure 2).
Pink eosinophilic material showing pale orange positivity with Congo red stain X 400
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This pink eosinophilic material showed pale orange positivity with congo red staining consistent with the diagnosis of amyloidosis (Figure 3).