Dexamethasone cyclophosphamide pulse therapy in lichen amyloidosis
: A case report.
The scrub use was more prevalent among lichen amyloidosis patients (85%), followed by biphasic amyloidosis (71.42%) and macular amyloidosis (63.63%).
Systemic conditions like hypercholesterolaemia was present in 7 (18.4%) patients, hypertension in 5 (13.2%), hypothyroidism in 3 (7.9%), and chronic renal disease in one patient with lichen amyloidosis. History of diabetes mellitus was present in 4 patients (10.5%) and one among these and an additional three were detected to have elevated random blood sugar on investigation.
Histopathologically (Table 2), 32 patients (84.2%) had features of lichen amyloidosis and 6 (15.7%) had features of macular amyloidosis.
The term biphasic amyloidosis is used when macular amyloidosis and lichen amyloidosis coexist.1 Lichenoid form usually is observed as hemispheric papules forming plaques on the shin or other extensor surfaces of the extremities, however back involvement as pigmented macules in a reticulate pattern is generally viewed in macular amyloidosis.3 First of all the lesions shows unilateral pattern, later symmetrical distribution is observed.4 Our case was distinctive from the other cases since the location of lichen amyloidosis lesions were mainly located on the back as well as the extensor aspects of the extremites.
Chronic irritation of the skin has been postulated as an etiological factor.5 It is suggested that amyloid deposition in macular amyloidosis and lichen amyloidosis is primarily caused by epidermal keratinocyte degeneration, any relationship between systemic amyloidosis has not been detected.6
* In this descriptive study, Chronic urticaria was seen in 4 cases (2%); 3 (1.5%) cases of Colloid milia, 1 case (0.5%) of Parapsoriasis, 2 cases each of Lichen amyloidosis
and Lichen sclerosus et atrophicus were seen; 1 case (0.5%) each of Favre-Racouchot syndrome, 2 cases each of Reactive perforating collagenosis and Granuloma annulare, 3 cases of Polymorphous light eruption, 1 case each of Pruritus ani, Pyogenic granuloma and Lupus profundus were seen.
DISCUSSION: Macular amyloidosis is one of the forms of primary localized cutaneous amyloidosis, others being lichen amyloidosis, nodular amyloidosis and biphasic (macular +lichen) amyloidosis.
Etretinate for the treatment of lichen amyloidosis. Arch Dermatol.