title: Effective treatment of nodular amyloidosis with carbon dioxide laser.
abstract: BACKGROUND
  Nodular amyloidosis is a rare form of localized cutaneous amyloidosis that is characterized by nodules located on the extremities, trunk, genitalia, or face. In treatment regimens, many approaches have been described, including carbon dioxide (CO2) laser therapy.
  
  
  OBJECTIVE
  We present a case of a 60-year-old white male with a 20-year history of disseminated waxy, purpuric, yellowish, and bullous skin lesions on the trunk and extremities. The skin changes were accompanied by pain during palpation and were temporarily pruritic.
  
  
  METHODS
  Based on histologic and direct immunofluorescence test findings, the diagnosis of cutaneous nodular amyloidosis was established. Skin lesions were treated with a CO2 laser. During surgery, treated tissue was found to be slightly friable, and there was a little problem with hemostasis that correlated with amyloid infiltration of the dermis and blood vessels. However, after 8 weeks, we observed clinical improvement of all treated areas with the presence of atrophic scars. In the regions of laser therapy, no recurrence of the disease was observed during a 12-month follow-up.
  
  
  CONCLUSIONS
  Based on these results, we conclude that CO2 laser has a beneficial effect in the treatment of nodular amyloidosis; however, surgery procedures may be associated sometimes with tissue friability and poor hemostasis.
authors.affiliation: Department of Dermatology, Medical University of Lodz, Lodz, Poland. aleksandra.lesiak@umed.lodz.pl
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Lesiak
authors.forename: Adam
authors.initials: A
authors.lastname: Rakowski
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Brzezinska
authors.forename: Michał
authors.initials: M
authors.lastname: Rogowski-Tylman
authors.forename: Pawel
authors.initials: P
authors.lastname: Kolano
authors.forename: Anna
authors.initials: A
authors.lastname: Sysa-Jedrzejowska
authors.forename: Joanna
authors.initials: J
authors.lastname: Narbutt
mesh_terms: D000686:Amyloidosis / Q000473:pathology / Q000601:surgery*; D003937:Diagnosis, Differential; D005145:Face; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology*; D012871:Skin Diseases / Q000473:pathology / Q000601:surgery*