This communication concerns two patients in whom amber-colored xanthelasma-like papules on the eyelids were an early sign of systemic amyloidosis. These seldomillustrated lesions (Fig 1 and 2),1-3 termed here amyloidosis palpebrarum, are sufficiently characteristic to suggest the diagnosis immediately.
—A 50-year-old white man entered the hospital complaining of dysphagia and weight loss. Three months earlier he had undergone cervical laminectomy in another hospital because of weakness and progressive wasting of both upper extremities. The operative findings were normal.Physical examination disclosed wasting of the proximal muscles in all extremities, a symmetrical sensori motor peripheral neuropathy, and glistening, violaceous, painless papules on both upper eyelids (Fig 1). After minor abrasion, the lesions on his eyelids became purpuric (Fig 2). The patient subsequently recalled that these cutaneous eruptions had been present for six months.The hematocrit value was 36%, and total white blood cell count (WBC), 13,000/cu