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Pruritic Patches on the Back and Papules on the Legs—Diagnosis
Arch Dermatol. 2007;143(2):255-260.
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Diagnosis: Primary localized cutaneous amyloidosis (PLCA) (cutaneous lichen amyloidosis and macular amyloidosis).
MICROSCOPIC FINDINGS AND CLINICAL COURSE
Histopathologic examination of lesional skin from one of the legs (Figure 3) and the back (Figure 4) showed globular deposits of homogeneous, eosinophilic material within the papillary dermis. The diagnosis of PLCA was confirmed by positive staining with Congo red. The patient noted relief from pruritus and flattening of the lesions on her legs after 4 weeks of treatment with clobetasol propionate ointment under occlusion.
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DISCUSSION
Primary localized cutaneous amyloidosis is the extracellular deposition of a fibrillar proteinaceous material in the skin, without systemic organ involvement. The pathogenesis appears to involve fibrillar protein that is derived from damaged keratinocytes.1-2 Frictional forces may have a role in the development of PCLA. Macular amyloidosis presents as pruritic, hyperpigmented, rippled patches on the back, typically in the interscapular region of adults. This condition overlaps, or may coexist with, notalgia paresthetica.3 Lichen amyloidosis presents as . . . [Full Text of this Article]
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Arch Dermatol. 2007;143(2):255-260.
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