Characteristic dermoscopic features of primary cutaneous amyloidosis: a study of 35 cases.
BACKGROUND
Primary cutaneous amyloidosis (PCA) is a relatively common skin disorder among Asians and South Americans. It is usually diagnosed clinically. However, for cases with atypical presentations, the diagnosis can be a challenge and skin biopsy may be necessary. Dermoscopy has been proved to be a valuable, noninvasive tool in the diagnosis of cutaneous pigmented diseases. Most lesions of PCA show hyperpigmentation and the major histopathological abnormalities of PCA occur in the epidermis and dermal papillae. Dermoscopy might be a powerful tool to provide valuable information for the diagnosis of PCA.


OBJECTIVE
We aimed to find characteristic dermoscopic features of PCA.


METHODS
Cases with typical clinical presentations of PCA, either macular or lichen subtypes, were included in this study. All were evaluated using a hand-held, polarized and nonpolarized dermoscope.


RESULTS
A total of 35 patients with clinically diagnosed PCA were enrolled. Eighteen patients had lesions consistent with macular amyloidosis and 17 with lichen amyloidosus. We found two major dermoscopic patterns characteristic of PCA. The most common dermoscopic finding of PCA was a central hub, which could be either white or brown, surrounded by various configurations of pigmentation. For cases of lichen amyloidosus with prominent hyperkeratosis, the central hub was replaced by a scar-like morphology.


CONCLUSIONS
This is the first study to report the characteristic dermoscopic features of PCA. We demonstrate that the use of a dermoscope may assist in achieving an accurate diagnosis of PCA.
Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.
Y Y
YY
Chuang
D D
DD
Lee
C S
CS
Lin
Y J
YJ
Chang
M
M
Tanaka
Y T
YT
Chang
H N
HN
Liu
D000686:Amyloidosis / Q000473:pathology*; D028226:Amyloidosis, Familial / Q000473:pathology; D046169:Dermoscopy / Q000379:methods*; D003937:Diagnosis, Differential; D006801:Humans; D000075363:Immunoglobulin Light-chain Amyloidosis; D008548:Melanosis / Q000473:pathology; D009450:Neurodermatitis / Q000473:pathology; D012873:Skin Diseases, Genetic / Q000473:pathology; D012875:Skin Diseases, Metabolic / Q000473:pathology*