FotoFinder Dermoscopy Analysis and Histopathological Correlation in Primary Localized Cutaneous Amyloidosis

Background: Primary localized cutaneous amyloidosis (PLCA) causes extracellular proteinaceous deposits in skin. It is clinically divided into macular amyloidosis, lichen amyloidosis and nodular amyloidosis. Atypical presentations of PLCA make the diagnosis challenging, requiring biopsy to confirm amyloid deposition in the upper papillary dermis. Objectives: This study used FotoFinder dermoscopy to characterize lichen and macular amyloidosis and correlated the dermoscopic features with histopathological findings. Methods: This cross-sectional study enrolled patients with a clinical and histopathological diagnosis of PLCA. Dermoscopic examination was performed using the FotoFinder dermoscope, which provides a range of magnification from 20´ to 140´. Results: A total of 30 patients were included in the study. Common dermoscopic patterns of MA were white or brown central hubs, and common patterns of LA were white structureless, scar-like areas and central hubs. New dermoscopic findings were a day lily appearance in MA and white rosettes in LA. Conclusions: Dermoscopy plays a pivotal role in demonstrating characteristic findings of PLCA. These findings were well corelated with histopathology, thus avoiding unnecessary biopsy for arriving at an accurate diagnosis of PLCA.

A clinical study of primary cutaneous localized amyloidosis

<p class="abstract"><strong>Background:</strong> Amyloidosis refers to abnormal extracellular tissue deposition of one of the biochemically unrelated proteins that share certain characteristic staining properties such as apple green birefringence of congo red stained preparations under polarized light. Amyloid deposition may occur in many organs of the body (systemic amyloidosis) or may be restricted to one tissue site (localized amyloidosis).</p><p class="abstract"><strong>Methods:</strong> Observational study was conducted in the Department of Dermatology, Narayana Medical College and Hospital, Nellore. In this study of 70 patients a complete history and clinical data was taken including details of presenting complaints, age, site, duration, course of the disease was recorded. Special importance was given to the friction history using different scrubs, family history and photo exposure.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 70 patients of cutaneous amyloidosis 55 patients (78.6%) were of macular amyloidosis. Male:female ratio was 1:2.3. Majority of the patients were housewives (42.8%) and 28.5% of agriculturists. Majority of the patients (40) with cutaneous amyloidosis had disease duration between 2-5 years. In 70 patients of cutaneous amyloidosis 64.3% were symptomatic. 92% patients give history of using scrub. 50% of patients had history of photo exposure. Positive family history was seen in 7 patients (10%) and most common site involved was extensor aspect of arm.</p><p class="abstract"><strong>Conclusions:</strong> From our study it can be concluded that cutaneous amyloidosis is more common among females, most patients are symptomatic, majority have history of using scrub and photo exposure and most common site involved is extensor aspect of arm.</p><p class="abstract"> </p>

A study on efficacy of high fluence Q-switched neodymium doped yttrium aluminium garnet laser in macular amyloidosis

<p class="abstract"><strong>Background: </strong>Macular amyloidosis (MA) typically presents as small, dusky-brown or greyish pigmented macules, treatment of which remains challenging with topical and systemic therapies, however Q-switched neodymium-doped yttrium aluminium garnet (Nd:YAG) laser has proven to be an effective treatment modality to reduce hyperpigmentation. The aim of the study is to study the efficacy of Nd:YAG laser in the management of MA.</p><p class="abstract"><strong>Methods: </strong>30 female patients were treated with Q-switched Nd:YAG laser at 1064 nm with a spot size of 3 mm at a fluence of 6-7 J/cm², frequency of 2 Hz, for 350-500 pulses. Total number of pulses decreased with each treatment session as the intensity of the hyperpigmentation decreased. The procedure was repeated at one-month intervals for a total of 6 treatment sessions.</p><p class="abstract"><strong>Results: </strong>After completion of treatment sessions with Nd-YAG laser 36.66% patients showed &gt;50% improvement in the pigmentation. 66.6% patients were satisfied with the laser treatment. 33.3% patients showed &lt;25% improvement and unsatisfied with the treatment.</p><p class="abstract"><strong>Conclusion: </strong>MA remains an enigma and a source of concern for the suffering patients and physicians. Q-switched Nd-YAG laser 1064 nm has shown positive response in the reduction of pigmentation in MA.</p>