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Case 2-(a) hyperkeratotic brown papules on the extensor surface of the left thigh; (b,c) videodermoscopy (Canfield D200 EVO ) showing central white hubs (black arrow) with greyish-brown globules at the periphery (white arrow), erosion (blue arrow) and white collarette scaling (red arrow). Red globules (red asterisk) in the center of the white hub and thick, unfocused branching vessels intersecting the white hubs (black asterisk) are present.
Source publication
Primary cutaneous amyloidosis (PCA) is characterized by the extracellular deposition of amyloid in the skin without systemic involvement. It comprises several clinical variants, the most common of which are macular amyloidosis (MA) and lichen amyloidosis (LA). PCA is frequently observed in Asians, while it is considered to be very rare in Caucasian...
Contexts in source publication
Context 1
... addition, the patient suffered from type 2 diabetes. Upon admission, multiple firm papules and nodules were present on the upper and lower extremities, abdomen, back, and buttocks ( Figure 2a). Videodermoscopy (Canfield D200 EVO , Canfield Scientific GmbH, Bielefeld, Germany) showed central white hubs on a grayish-brown background, brown dots and globules at the periphery, a white collarette scaling surrounding some of the white hubs, and erosions. ...
Context 2
... (Canfield D200 EVO , Canfield Scientific GmbH, Bielefeld, Germany) showed central white hubs on a grayish-brown background, brown dots and globules at the periphery, a white collarette scaling surrounding some of the white hubs, and erosions. Vascular structures in the form of red globules and thick unfocused branching vessels intersecting the central hubs were observed as well (Figure 2b,c). A histopathological examination revealed hyperkeratosis, acanthotic epidermis, vessels with thickened walls in the dermis, chronic perivascular infiltrate composed of histiocytes and lymphocytes, pigment incontinence, and single melanophages. ...
Context 3
... addition, the patient suffered from type 2 diabetes. Upon admission, multiple firm papules and nodules were present on the upper and lower extremities, abdomen, back, and buttocks ( Figure 2a). Videodermoscopy (Canfield D200 EVO , Canfield Scientific GmbH, Bielefeld, Germany) showed central white hubs on a grayish-brown background, brown dots and globules at the periphery, a white collarette scaling surrounding some of the white hubs, and erosions. ...
Context 4
... (Canfield D200 EVO , Canfield Scientific GmbH, Bielefeld, Germany) showed central white hubs on a grayish-brown background, brown dots and globules at the periphery, a white collarette scaling surrounding some of the white hubs, and erosions. Vascular structures in the form of red globules and thick unfocused branching vessels intersecting the central hubs were observed as well (Figure 2b,c). A histopathological examination revealed hyperkeratosis, acanthotic epidermis, vessels with thickened walls in the dermis, chronic perivascular infiltrate composed of histiocytes and lymphocytes, pigment incontinence, and single melanophages. ...
Citations
... Previous reports on the dermoscopic features of PLCA were mostly presented using subjective metaphoric language [12]. Here, we provided descriptions of previously reported terms, such as 'two-zone pattern' and 'jigsaw puzzle pattern', using standard dermoscopic terminology. ...
Amyloid deposits can be the cause of many chronic diseases. Primary localized cutaneous amyloidosis (PLCA) is a chronic dermatologic condition with amyloid deposits in the papillary dermis. The most common types of the keratinocyte-derived form of PLCA include macular (MA), lichen (LA), and biphasic (BA) amyloidosis. The estimated prevalence of PLCA in the Asian population is 0.98/10,000, which is higher than in the European population; thus, epidemiologic data on PLCA in the Caucasian population are limited. We performed a retrospective single-center study analyzing epidemiologic characteristics of a Central European PLCA population. Epidemiologic data regarding age, sex, skin phototype (Fitzpatrick scale I–VI), disease duration, comorbidities, history of atopy, and family history of PLCA were collected. Clinical characteristics, localization of PLCA lesions, applied therapies and treatment outcomes were also analyzed. Dermoscopic characteristics were also evaluated. A total of 41 patients diagnosed with PLCA were included, with 22 presenting with macular, 18 with lichen, and 1 with biphasic amyloidosis. The male/female ratio was 16/25, and mean age at diagnosis was 54.6 ± 15.2 years (range 27–87 years). The mean age at the onset of PLCA was 53 ± 16.1 years (range 19–79 years) in MA, 46.7 ± 18.2 years (range 14–73 years) in LA, and 26 years in BA. The interscapular region in MA and the extensor surface of the lower extremities in LA proved to be localization-related areas. In our center, a wide range of therapeutic options was applied, with the most prescribed being topical corticosteroids in all types of PLCA. We presented a retrospective, monocentric study on the epidemiology of PLCA in the Central European region. By examining the medical data of a significant number of PLCA patients, we compared our epidemiologic data with that of the Asian PLCA population. Due to the rarity of the condition, further randomized controlled trials and guidelines are needed to improve therapeutic outcomes.
... Penyakit ini berkaitan erat dengan rasa gatal dan gangguan rasa nyaman, sehingga dapat menyebabkan gangguan psikologis. 4 PCA terdiri dari beberapa varian klinis, termasuk amiloidosis makula (MA), liken amiloidosis (LA), amiloidosis nodular (NA), amiloidosis bifasik (BA, kombinasi MA dan LA), amiloidosis kutis dyschromica (amyloidosis cutis dyschromica/ ACD), dan amiloidosis anosakral (AA). 2 LA merupakan bentuk amiloidosis kulit terlokalisasi primer yang paling sering dijumpai. LA muncul secara klinis sebagai papula multipel, sangat gatal, hiperpigmentasi, hiperkeratosis pada kaki bagian anterior, paha, dan lengan bawah yang kemudian menyatu menjadi plak. ...
... 7 Pada sebagian besar kasus, LA digambarkan dengan lesi putih pada bagian pusatnya terlihat seperti bekas luka dikelilingi oleh pigmentasi bervariasi, terutama dalam bentuk titik abu-abu-coklat, globul, atau seperti merica. 4 Gatal merupakan gambaran umum amiloidosis lichenoid kulit, 10-13 intensitasnya dapat menurunkan kualitas hidup pasien. 2 Diduga gatal pada lichenoid disebabkan oleh neuropati perifer yang menyebabkan berkurangnya ujung serabut saraf kulit di epidermis dan sambungan dermoepidermal di daerah lesi, dan oleh karena itu, dapat meningkatkan iritabilitasnya. 9 Aktivitas neuropati perifer berkorelasi dengan intensitas gatal. ...
Liken amiloidosis adalah bentuk umum amiloidosis kulit primer yang sering didapatkan pada populasi di Amerika Tengah dan Selatan, Timur Tengah, dan Asia. Penyebabnya tidak diketahui, diperkirakan oleh garukan didukung faktor genetik dan faktor virus. Diagnosis dikonfirmasi dengan deteksi deposit amiloid di dermis papiler. Pilihan terapi adalah dengan steroid topikal atau intralesi, antihistamin, agen retinoid, dan terapi terbaru laser dermabrasi. Prognosis umumnya baik, pada beberapa kasus mengakibatkan rasa gatal kronis yang dapat mengganggu kualitas hidup. Lichen amyloidosis is a common form of primary cutaneous amyloidosis, occurs mainly in Central and South America, the Middle East, and Asia. The cause is unknown, it is thought to be caused by scratching supported by genetic factors and viral factors. Diagnosis is confirmed by the detection of amyloid deposits in the papillary dermis. Treatment are with topical or intralesional steroids, antihistamines, retinoid agents, and laser dermabrasion. Prognosis is generally good, but in some cases, caused chronic itching that can interfere with the patient’s quality of life.
... Lichen amyloidosis occurs more frequently in men than in women, usually in the fifth or sixth decade of life, and is more common in Asians, while it is observed less frequently in Caucasian patients [7,8]. ...
... However, the literature lacks data on the clinical and dermoscopic presentation of lichen amyloidosis in patients with skin phototype I or II. In the cases described in the literature, compared to the dermatoscopic features of lichen amyloidosis in patients with a darker skin phototype, Caucasian patients presented less pronounced pigmentation and more prominent vascular structures [7]. ...
... Choroba występuje typowo u pacjentów z fototypem III-IV, jest opisywana najczęściej w Azji i Ameryce Południowej. Rzadziej obserwuje się ją u osób rasy kaukaskiej [7,8]. ...
... It can promote microcirculation, accelerate metabolism, and restore damaged tissues in the lesional area through the regulation of cutaneous nerves, which in turn can eliminate or attenuate pathological features such as edema, hyperemia, exudation, adhesion, calcification, contractures, and ischemia [5]. Fire needle also can stimulate vascular dilatation and local edema of the lesion, which promotes transdermal absorption and maximizes the efficacy of the topical agents [6]. ...
Background:
Primary cutaneous amyloidosis (PCA) is a chronic metabolic skin disease that has a detrimental impact on physical and mental health. It appears as mossy papules and severe itching, which is long-term and recurrent. Traditional treatments are unsatisfactory, especially for refractory cases. Fire needle therapy, which is widely used in China, has shown good clinical efficacy, as well as advantages concerning safety and cost. Clinical reports about fire needle treatment of this disease are few at present.
Case summary:
We report two older men who had developed maculopapules with itchiness on the trunk and arms for more than 10-15 years. Due to the dermatopathological findings, PCA was our primary consideration. They received topical halometasone cream and pretreatment with fire needle for 8-16 wk. Both patients showed significant improvement of lesions. Neither patient had recurrence with a minimum of 2 years of follow-up.
Conclusion:
Topical halometasone cream and pretreatment with fire needle could be a fast, safe, and economic treatment for PCA.
... (Video)dermoscopy is a non-invasive diagnostic technique that has a well-established role in the early diagnosis of melanoma and non-melanoma skin cancer. In recent years, this method has also been increasingly used in the assessment of inflammatory dermatoses [5,6]. So far, only a few reports have been published on the dermoscopic features of DM [7][8][9][10][11][12][13][14][15]. ...
Background:
(Video)dermoscopy is a non-invasive diagnostic technique that has a well-established role in dermatooncology. In recent years, this method has also been increasingly used in the assessment of inflammatory dermatoses. So far, little is known about the (video)dermoscopic features of dermatomyositis (DM).
Methods:
Consecutive patients with DM were included in the study and videodermoscopic assessments of the nailfolds, scalp, and active skin lesions were performed.
Results:
Fifteen patients with DM (10 women and 5 men) were included. Capillaroscopy showed elongated capillaries (90.9%), avascular areas (81.8%), disorganized vessel architecture (81.8%), tortuous capillaries (72.7%), dilated capillaries (72.7%), and hemorrhages (72.7%). The trichoscopic findings included linear branched vessels (80.0%), linear vessels (60.0%), linear curved vessels (53.3%), perifollicular pigmentation (40.0%), perifollicular erythema (33.3%), scaling (20.0%), white (20.0%) or yellow (20%) interfollicular scales, and white (20.0%) or pinkish (13.3%) structureless areas. Polymorphic vessels of an unspecific distribution and white or pink structureless areas were frequently observed under dermoscopy in cutaneous manifestations of DM, including Gottron's papules and Gottron's sign.
Conclusions:
Dermoscopy of the nailfolds (capillaroscopy), scalp (tricoscopy), and active cutaneous lesions may be of value in the preliminary diagnosis of DM.
