Macroglossia is the most common head and neck manifestation of amyloidosis, and appears in between 15 and 20 percent of patients with light chain disease. The tongue can grow to massive proportions and can be smooth or possess a variety of polypoid appendages which form as the tongue grows against gaps in the teeth. In addition to its large size, the tongue becomes adynamic, firm and friable and may cause problems with deglutition, speech, and breathing. It frequently causes sialorrhea, and tissue may break down and hemorrhage. In addition, the gross facial deformity may lead to social withdrawal.
Dermatologic lesions are the next most common head and neck manifestations.
The most characteristic are waxy, purpuric lesions located around the upper eyelids in patients with systemic disease. Other skin findings include macular lesions, papular lesions, and a modular or tumefactive form. The laryngotracheal system is the next most common site. Amyloidosis constitutes approximately one percent of all benign lesions of the larynx. It usually occurs as nodules or polypoid lesions and can be located anywhere in the larynx or trachea.