What Causes My Toenail Get Separated And Fallen Off?

My big toenail on my right foot has just separated from the nail bed and fallen off. I have read that onychomycosis can be a symptom of systemic amyloidosis. I was diagnosed at the age of 14 with primary nodular cutaneous amyloidosis and am now 38 years old. To this date my amyloidosis has been localized to my extremities with no care given. In the past year I have developed 2 new areas of concern on either breast and now have had a toenail fall off. Should I be concerned that the amyloidosis has become internally systemic?