title: Amyloid deposition is frequently observed in skin lesions of hypertrophic lupus erythematosus.
abstract: Four cases of Hypertrophic Lupus Erythematosus (HLE) were reported. The lesions of HLE were observed on the forearms, face and hands in all four cases. Clinically, the lesions were erythematous, hyperkeratotic plaques. The clinical course was marked by chronicity and progression of the lesion. Histologically, marked hyperkeratosis, parakeratosis, acanthosis, degenerative changes of basal cells in H/E stain, and thickened, multilayered basement membrane in PAS stain, were observed. The observations of Dylon stain revealed that localized amyloid deposition was observed in all four cases of HLE lesions, as fluorescent-orange colored amyloid deposits in the papillary dermis and subepidermal areas at near orjust below the dermo-epidermal junction appeared under fluorescent microscope. On the basis of clinical and histological observations, we suggest that chronic irritation, such as sunlight exposure over a long-duration, might have caused the characteristic abnormalities at the dermo-epidermal junction and also initiated the frequency of amyloid deposits locally secondary to the diseases. We compared our HLE cases to other types of lupus erythematosus (LE) skin lesions, as to whether deposition of amyloid materials were frequently observed or not. Amyloid deposition was observed in one case of DLE and none of the SLE cases. Localized amyloid deposition was more frequently observed in skin lesions, secondary to HLE disease, as compared to other types of LE.
authors.affiliation: Department of Dermatology, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan.
authors.forename: Mohammed Abul Kasem
authors.initials: MA
authors.lastname: Khan
authors.forename: Motoyoshi
authors.initials: M
authors.lastname: Maruno
authors.forename: Noor Mohammad
authors.initials: NM
authors.lastname: Khaskhely
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Uezato
authors.forename: Shigeo
authors.initials: S
authors.lastname: Nonaka
mesh_terms: D000368:Aged; D000682:Amyloid / Q000378:metabolism*; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008179:Lupus Erythematosus, Discoid / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000378:metabolism* / Q000473:pathology
chemical_list: D000682:Amyloid