Histopathology does not discriminate between localized and systemic forms of amyloidosis. 1 Histopathologic examination of nodular amyloidosis demonstrates collections of eosinophilic proteinaceous material throughout the dermis 1 (Figure 2). This contrasts with lichenoid and macular amyloidosis, which are limited to the papillary dermis. 2 Mass spectrometry can identify the type of amyloid, which in our patient revealed AL type deposition. 5 Further workup for systemic amyloidosis involves comprehensive testing, primarily testing for the presence of a paraproteinemia. 2 Once amyloid fibrils are deposited, they are difficult to remove. 1 Destructive methods such as surgical excision have been performed. 3 CO2 laser vaporization is an option; however, it is associated with complications including tissue friability. 1 Lifelong clinical monitoring is integral, however, the prognosis is optimistic. 3 This case report is the first to report NPLCA presenting with involvement of legs and leg ulceration.