What Is Your Diagnosis? Primary Localized Cutaneous Nodular Amyloidosis

A 66-year-old man presented with lesions growing on the nose of 5 years’ duration. He reported intermittent bleeding and purulent discharge from the lesions but denied any associated pain or pruritus. He was treated for rosacea, alternating between tetracycline and doxycycline for 4 years prior to presentation. Despite treatment, the lesions steadily increased in number and size. The patient’s medical history was otherwise unremarkable, and he lacked any constitutional symptoms.