BH10: Nailing the Diagnosis

The document presents a case study of a 60-year-old man with nail changes and lesions on his hands, initially suspected to be related to diabetes mellitus. However, further investigation revealed advanced cardiac amyloidosis, confirmed by a Congo red stain showing apple-green birefringence and subsequent cardiac MRI. The nail pathology, characterized by koilonychia and longitudinal fissuring, is hypothesized to result from amyloid infiltration. This case underscores the importance of considering amyloidosis in differential diagnoses for patients with similar nail findings and assessing for systemic involvement.