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Sadeghi NB, Ziemer CM, Wu SB, Miedema JR, Blasiak RC. Persistent Hyperpigmented Macules on the Scalp and Face: Answer. Am J Dermatopathol 2024; 46:257-258. [PMID: 38488350 DOI: 10.1097/dad.0000000000002655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Affiliation(s)
- Nakisa B Sadeghi
- School of Medicine, University of North Carolina, Chapel Hill, NC; and
| | - Carolyn M Ziemer
- Department of Dermatology, University of North Carolina, Chapel Hill, NC
| | - Sam B Wu
- Department of Dermatology, University of North Carolina, Chapel Hill, NC
| | - Jayson R Miedema
- Department of Dermatology, University of North Carolina, Chapel Hill, NC
| | - Rachel C Blasiak
- Department of Dermatology, University of North Carolina, Chapel Hill, NC
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Mokhtari F, Yazdanpanah M, Iraji F, Asilian A, Siadat A, Tavakolifard N. Evaluation and comparison of Q-switched Nd: YAG laser 1064 nm and Er: YAG laser 2940 nm in the treatment of macular amyloidosis. Lasers Med Sci 2024; 39:22. [PMID: 38165508 DOI: 10.1007/s10103-023-03965-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
Macular amyloidosis (MA) is one of the most common types of primary localized cutaneous amyloidosis (PLCA), distributed predominantly over the trunk and extremities. Due to the vast therapeutic options, this study aims to compare the effectiveness of Q-switched Nd: YAG laser 1064 nm and Er: YAG laser 2940 nm in treating MA. This clinical trial was performed in 2020-2021 on 33 women with MA. In each patient, the lesion was randomly divided into two areas, A and B. Area A underwent four treatment sessions with 4-week intervals of Q-switched Nd: YAG laser 1064 nm. Area B underwent four treatment sessions with an Er: YAG laser 2940 nm at 4-week intervals. Degree of basal pigmentation and degree of pigmentation after treatment, pruritus intensity, before and after the treatment, and patient and physicians' satisfaction were measured and compared. The pruritus in patients improved significantly after the study (P < 0.001), but no significant differences could be observed between the two groups regarding the improvements (P > 0.05). We also found no significant differences between the two groups of patients regarding patient and physicians' satisfaction rates (P > 0.05). The use of both Q-switched Nd: YAG laser and Er: YAG laser resulted in improvements in terms of pruritus, patient and physicians' satisfaction, and total improvement in pigmentation of the lesions.
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Affiliation(s)
- Fatemeh Mokhtari
- Skin Disease and Leishmaniasis Research Center, Department of Dermatology, Medicine School, Isfahan University of Medical Science, Isfahan, Iran
| | - Maral Yazdanpanah
- Skin Disease and Leishmaniasis Research Center, Department of Dermatology, Medicine School, Isfahan University of Medical Science, Isfahan, Iran
| | - Fariba Iraji
- Skin Disease and Leishmaniasis Research Center, Department of Dermatology, Medicine School, Isfahan University of Medical Science, Isfahan, Iran.
| | - Ali Asilian
- Skin Disease and Leishmaniasis Research Center, Department of Dermatology, Medicine School, Isfahan University of Medical Science, Isfahan, Iran
| | - AmirHossein Siadat
- Skin Disease and Leishmaniasis Research Center, Department of Dermatology, Medicine School, Isfahan University of Medical Science, Isfahan, Iran
| | - Negah Tavakolifard
- Department of Community Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Vaghasia A, Kamat S, Kansara K, Dharmender J, Shah BJ. A prospective comparative study of efficacy and safety of 15% trichloroacetic acid peel, 35% glycolic acid peel and Q-switched Nd-YAG laser in patients of macular amyloidosis. J Cutan Aesthet Surg 2024; 17:41-49. [PMID: 38736865 PMCID: PMC11086938 DOI: 10.4103/jcas.jcas_55_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Background The unappealing appearance of skin in macular amyloidosis (MA) interferes with the patient's quality of life, and treating the condition has been challenging. Aims and Objectives To compare the efficacy and safety of 15% trichloroacetic acid (TCA) peel, 35% glycolic acid (GA) peel, and Q-switched Nd-YAG Laser in MA. Materials and Methods Open, prospective study was conducted over 2 years, where after fulfilling the criteria, randomization was done into three groups. Group A: 15% TCA peel; Group B: 35% GA peel; Group C: Q-switched Nd-YAG Laser. Procedures were repeated at monthly intervals for six sittings. On each visit, patients were scored on the following parameters: color score, visual analog score (VAS), physician global assessment (PGA) scale, subjective improvement, and adverse effects. Results A total of 75 patients (25 patients in each group) completed the treatment. The mean age of study-population was 35.68 ± 9.8 years, with female to male ratio of 11.5:1. The mean change in color score (1.68) was more by Group A, followed by Group C (1.4), followed by Group B (1.16). Similar results were noted by subjective improvement, VAS, and PGA. Adverse events were more in Group A, followed by Group C, followed by Group B. No patient showed permanent adverse events. Conclusion TCA-peel showed superior results over Nd-YAG laser and glycolic-acid peel. TCA-peel being cost-effective with excellent acceptability should be considered a treatment modality.
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Affiliation(s)
- Aditi Vaghasia
- Department of Skin & V. D., Civil Hospital, B. J. Medical College, Ahmedabad, Gujarat, India
| | - Shruti Kamat
- Department of Skin & V. D., Civil Hospital, B. J. Medical College, Ahmedabad, Gujarat, India
| | - Kajal Kansara
- Department of Skin & V. D., Civil Hospital, B. J. Medical College, Ahmedabad, Gujarat, India
| | - J Dharmender
- Department of Skin & V. D., Civil Hospital, B. J. Medical College, Ahmedabad, Gujarat, India
| | - Bela J Shah
- Department of Skin & V. D., Civil Hospital, B. J. Medical College, Ahmedabad, Gujarat, India
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El-Samanoudy SI, Gawdat HI, Fouda KM, Abdelkader HA. Dermoscopy aids in differentiating primary cutaneous amyloidosis and post-inflammatory hyperpigmentation: A clinico-dermoscopic-histopathaological study. J Cosmet Dermatol 2022; 21:6434-6440. [PMID: 36017750 DOI: 10.1111/jocd.15332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Primary cutaneous amyloidosis (PCA) and post-inflammatory hyperpigmentation (PIH) are common causes of cutaneous hyperpigmentation that are usually diagnosed clinically. However, their presentations are sometimes atypical, and their differentiation is difficult. Dermoscopy is a valuable diagnostic tool for pigmented diseases that might aid in their diagnosis. OBJECTIVE To describe the characteristic dermoscopic features of PCA and PIH together with histopathological correlation, and to differentiate between these conditions in a non-invasive way. METHODS Fifty-two patients with PCA (n = 26) and PIH (n = 26) were enrolled. A detailed history, skin examination, dermoscopic examination using handheld and video dermoscopy, and histopathological evaluation were performed. RESULTS A statistically significant difference could be detected between PCA and PIH in terms of the duration of the disease (p = 0.027), symmetry (p = 0.044), rippling (p < 0.001), and back affection (p = 0.048). On dermoscopic examination, central hubs were seen more in the PCA group (p < 0.001) with different patterns of peripheral pigmentation. Histopathologically, the number of melanophages per high-power field was significantly higher in the PCA group (p = 0.013). CONCLUSION The results of this study shed the light on the potential of dermoscopy as a non-invasive diagnostic tool in differentiating between doubtful cases of PCA and PIH.
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Affiliation(s)
| | - Heba I Gawdat
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Kholoud M Fouda
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
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High-Frequency Electrosurgery for Generalized Lichen Amyloidosis. Dermatol Surg 2022; 48:1259-1260. [DOI: 10.1097/dss.0000000000003614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Radiation as a Tool against Neurodegeneration-A Potential Treatment for Amyloidosis in the Central Nervous System. Int J Mol Sci 2022; 23:ijms232012265. [PMID: 36293118 PMCID: PMC9603404 DOI: 10.3390/ijms232012265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/07/2022] [Accepted: 10/12/2022] [Indexed: 11/20/2022] Open
Abstract
Radiotherapy (RT) is a relatively safe and established treatment for cancer, where the goal is to kill tumoral cells with the lowest toxicity to healthy tissues. Using it for disorders involving cell loss is counterintuitive. However, ionizing radiation has a hormetic nature: it can have deleterious or beneficial effects depending on how it is applied. Current evidence indicates that radiation could be a promising treatment for neurodegenerative disorders involving protein misfolding and amyloidogenesis, such as Alzheimer's or Parkinson's diseases. Low-dose RT can trigger antioxidant, anti-inflammatory and tissue regeneration responses. RT has been used to treat peripheral amyloidosis, which is very similar to other neurodegenerative disorders from a molecular perspective. Ionizing radiation prevents amyloid formation and other hallmarks in cell cultures, animal models and pilot clinical trials. Although some hypotheses have been formulated, the mechanism of action of RT on systemic amyloid deposits is still unclear, and uncertainty remains regarding its impact in the central nervous system. However, new RT modalities such as low-dose RT, FLASH, proton therapy or nanoparticle-enhanced RT could increase biological effects while reducing toxicity. Current evidence indicates that the potential of RT to treat neurodegeneration should be further explored.
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Ahramiyanpour N, Akbari Z, Sarasyabi MS, Aflatoonian M, Saki N, Shafie'ei M. The therapeutic role of lasers in primary localized cutaneous amyloidosis: a systematic review. Lasers Med Sci 2022; 37:799-813. [PMID: 34611800 DOI: 10.1007/s10103-021-03429-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
Abstract
With the investigation of the efficacy of laser therapy in primary localized amyloidosis(PLCA) only recently starting to materialize, we aimed to review the currently available studies of laser therapy in the management of the disease. We searched PubMed, Scopus, Embase, Web of Science, Cochrane, and ProQuest online databases with a specified search strategy, assessed the quality of each study, and then extracted the eligible data. Five RCTs(randomized controlled trials), one non-randomized controlled trial, three case series, and nine case reports(18 in total) were included. Overall, carbon dioxide (CO2), neodymium-doped:yttrium aluminum garnet (Nd:YAG), pulsed dye (PDL), Er (Erbium):YAG, and yttrium/erbium fiber were the studied lasers. One hundred fifty-five cases in total underwent laser therapy, with CO2 being the most frequent laser. Almost all studies demonstrated significantly desirable outcomes, while only mild and transient side effects were noted. Even though the studies' results were significant, we noticed that implementing a consistent methodology and a standardized objective assessment method was missing. Therefore, we recommend that future studies be conducted with less heterogeneous data for a more definite conclusion.
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Affiliation(s)
- Najmeh Ahramiyanpour
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Akbari
- Faculty of Medicine, Kerman University of Medical Sciences, Haft Bagh Alavi Blvd, Postal Code: 7616913555, Kerman, Iran
| | - Mohammad Sharifi Sarasyabi
- Faculty of Medicine, Kerman University of Medical Sciences, Haft Bagh Alavi Blvd, Postal Code: 7616913555, Kerman, Iran
| | - Mahin Aflatoonian
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Nasrin Saki
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Dermatology Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Shafie'ei
- Faculty of Medicine, Kerman University of Medical Sciences, Haft Bagh Alavi Blvd, Postal Code: 7616913555, Kerman, Iran.
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Ghassemi M, Roohaninasab M, Kamani SA, Sadeghzadeh-Bazargan A, Goodarzi A. Comparison of the efficacy and safety of intralesional injection of tranexamic acid and the topical application of Kligman combination drug in the treatment of macular amyloidosis. Dermatol Ther 2021; 35:e15213. [PMID: 34797597 DOI: 10.1111/dth.15213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 01/19/2023]
Abstract
Macular amyloidosis (MA) is a common form of cutaneous amyloidosis that manifests as dark spots consisting of brown pigments with a rippled pattern on the skin, and the treatment of this condition is highly challenging. The aim of this study was to compare the efficacy and safety of intralesional injection of tranexamic acid (TXA) and topical application of Kligman combination drug in the treatment of macular amyloidosis. In this double-blind clinical trial, a total of 43 patients, who were diagnosed with MA, were treated with two different methods of intralesional injection of tranexamic acid and topical application of Kligman combination drug. Both therapeutic methods were effective in improving MA and significantly reduced hyperpigmentation of the treated areas, but tranexamic acid was significantly more effective than the Kligman combination drug. Significantly, greater improvements were observed in the group of patients treated with tranexamic acid. In the tranexamic acid treatment group, ΔE was reduced from 11.39 in the first session to 8.53 in the third session, and in the Kligman treatment group, it was reduced from 8.79 in the first session to 6.32 in the third session (p < 0.05). In addition, the pruritus score in patients treated with topical tranexamic acid injection was lower compared to the patients treated with the topical application of the Kligman combination drug. The results of this study demonstrated the significant positive effects of both treatment methods, but in terms of reducing melanin content, intralesional injection of tranexamic acid was a more effective method. Both treatments considered safe for MA. In tranexamic acid group, patients logically experienced a tolerable pain during injection but they significantly had significantly lower local pruritic discomfort during study. So, based on the positive findings of this study we suggest to use tranexamic acid in combination with other effective therapeutic methods for treatment of MA especially use of its topically applied form in combination with non-aggressive needling that results in better drug delivery without the experience of injection pain. Selection of the best administration route of tranexamic acid for hyperpigmented lesions depends on the each patient characteristic and their previous theraputic results that may vary case by case.
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Affiliation(s)
- Mohammadreza Ghassemi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Masoumeh Roohaninasab
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Seyed Abolfazl Kamani
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Afsaneh Sadeghzadeh-Bazargan
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
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Primary Localized Cutaneous Amyloidosis of Keratinocyte Origin: An Update with Emphasis on Atypical Clinical Variants. Am J Clin Dermatol 2021; 22:667-680. [PMID: 34286474 DOI: 10.1007/s40257-021-00620-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2021] [Indexed: 01/19/2023]
Abstract
Amyloid is a protein derived from at least 20 different substances. Once misfolded, it results in a group of cutaneous and systemic conditions. Primary localized cutaneous amyloidosis of keratinocyte origin is a very common subtype that can manifest either as lichen or macular amyloidosis, lacking systemic involvement. Lichen amyloidosis often presents as multiple hyperpigmented papules on the lower extremities whereas macular amyloidosis is classically characterized by dark brown rippled macules on the interscapular area. Review of the literature reveals that in addition to the classical presentation of primary localized cutaneous amyloidosis there exists a plethora of various manifestations that can be grouped into either geographic or morphologic categories. This review provides clinicians with the intimate knowledge of these presentations and summarizes the available treatment modalities.
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Fawzy MM, Kamel MM, El Maadawi Z, Abdel Hady R, Osman MA. Fractional Erbium-Doped Yttrium Aluminum Garnet Laser in the Treatment of Primary Cutaneous Amyloidosis. Dermatol Surg 2021; 47:e205-e211. [PMID: 33731571 DOI: 10.1097/dss.0000000000002994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although various treatments are currently available for primary cutaneous amyloidosis (PCA), there is no entirely satisfactory treatment. Recently, fractional ablative lasers are claimed to have therapeutic effects for PCA. OBJECTIVE To evaluate the efficacy and safety of fractional Er:YAG laser for the treatment of PCA. METHODS AND MATERIALS Ten patients with macular and lichen amyloidosis received 4 treatment sessions with 4-week intervals. The outcome was assessed clinically (degree of pigmentation, rippling, lichenification, and itching) through photographs and histologically (amount of amyloid, melanin, epidermal thickness, and depth of rete ridges) through biopsy specimens stained with hematoxylin-eosin, Congo red, and Fontana-Masson stain. Patients were followed up for 3 months after the final treatment. RESULTS At 3-month follow-up, fractional Er:YAG laser exhibited a significant clinical and histological improvement. Patient satisfaction concurred with physicians' evaluations. Recurrence was detected in 1 patient. CONCLUSION In light of the authors' findings, fractional Er:YAG laser offered a great clinical and histological efficacy with excellent safety profile. Careful laser selection based on making a compromise between efficacies and safeties may improve outcome.
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Affiliation(s)
- Marwa M Fawzy
- Dermatology Department, Kasr Al Aini Hospital, Faculty of Medicine, Cairo University, ICDP-UEMS, Giza, Egypt
| | - Marwa M Kamel
- Dermatology Department, Kasr Al Aini Hospital, Faculty of Medicine, Cairo University, ICDP-UEMS, Giza, Egypt
| | - Zeinab El Maadawi
- Histology Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | | | - Mai Abdelraouf Osman
- Dermatology and Laser at Dermatology Unit, Medical Laser Applications-National Institute of Laser Enhanced Sciences (NIlES), Cairo University, Giza, Egypt
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Wang M, Lin Y, Wu W, Yu Y, Liu X, Gao X, Liu H. Treatment of lichen amyloidosis with fractional CO 2 laser and topical steroid: a preliminary study of 10 cases. Lasers Med Sci 2020; 36:1123-1127. [PMID: 33236201 DOI: 10.1007/s10103-020-03188-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Meiling Wang
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Yan Lin
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Weizhi Wu
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Yongmei Yu
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Xiaodong Liu
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Xiaoyuan Gao
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Huaxu Liu
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China.
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Nilforoushzadeh MA, Zolghadr S, Heidari-Kharaji M, Alavi S, Mahmoudbeyk M. A comparative study of the efficacy of fractional neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy alone and in combination with erbium:YAG laser therapy: tracing and objective measurement of melanin index in macular amyloidosis. Lasers Med Sci 2020; 35:1171-1177. [DOI: 10.1007/s10103-020-02954-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 01/02/2020] [Indexed: 10/25/2022]
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Abstract
Primary localized cutaneous amyloidosis (PLCA) occurs when amyloid is deposited only within the skin and there is no evidence of systemic involvement. Nodular amyloidosis is the rarest subtype of PLCA. It typically involves the acral regions but can sometimes present on the head and neck. The condition usually presents clinically as a single tan or yellow nodule or plaque that may appear waxy. Herein, we present a rare case of a 66-year-old man with nodular amyloidosis on the lower back.
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Affiliation(s)
- Yelena Dokic
- Dermatology, Baylor College of Medicine, Houston, USA
| | - Paul Subrt
- Dermatology, Katy Westside Dermatology, Houston, USA
| | - Jaime Tschen
- Dermatology, St. Joseph Dermatopathology, Houston, USA
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Radmanesh M, Ghanatir F, Radmanesh R. Comparing the efficacy of pulsed dye laser, Q-Switched Nd-YAG, CO2, and combined CO 2 and Q-Switched Nd-YAG lasers for the treatment of cutaneous macular amyloidosis. J DERMATOL TREAT 2019; 32:258-260. [PMID: 31415215 DOI: 10.1080/09546634.2019.1654071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND No topical and systemic treatment is proven to be effective on Cutaneous Macular Amyloidosis (CMA). The physical removal of the deposited protein by lasers may be a better choice. OBJECTIVE To compare the efficacy of different lasers including Pulsed dye laser (PDL), 1064 mode of Q-Switched Nd-YAG, CO2, and combined CO2 and Q-Switched Nd:YAG lasers for the treatment of CMA. PATIENTS AND METHOD 17 adult female patients with clinical CMA and histopathological confirmation were included in this study. Four close 1 by 1 cm2 areas were treated simultaneously with PDL, Q-Switched Nd-YAG, CO2 and combined CO2 and Nd-YAG Lasers. The energy used for 585 nm PDL were 9 J/cm2 with the spot size of 5 mm. The energy used for 1064 nm mode of Nd-YAG laser was 5 Joules/cm2, with the spot size of 4 mm, and the frequency of 10 hertz. The energies used for CO2 laser were 4 and 3.5 Micro Joules for the first and second Passes. RESULTS No desirable result obtained after PDL therapy. The Q-Switched Nd-YAG was effective in only 3 patients. All areas treated with CO2 laser were cleared. CONCLUSION The CO2 laser is seems to be the most effective laser treatment of CMA.
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Affiliation(s)
| | - Forough Ghanatir
- Department of Dermatology, Ahvaz Jundishapur Univesity of Medical Sciences, Ahvaz, Iran
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Weidner T, Illing T, Elsner P. Primary Localized Cutaneous Amyloidosis: A Systematic Treatment Review. Am J Clin Dermatol 2017; 18:629-642. [PMID: 28342017 DOI: 10.1007/s40257-017-0278-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Primary localized cutaneous amyloidosis (PLCA) is characterized by extracellular deposition of heterogenic amyloid proteins in the skin without systemic involvement. Lichen amyloidosis, macular amyloidosis, and (primary localized cutaneous) nodular amyloidosis are different subtypes of PLCA. OBJECTIVE The aim of this study was to review the current reported treatment options for PLCA. METHODS This systematic review was based on a search in the PubMed database for English and German articles from 1985 to 2016. RESULTS Reports on the treatment of PLCA were limited predominantly to case reports or small case series. There were a few clinical trials but these lacked control groups. A variety of treatment options for PLCA were reported including retinoids, corticosteroids, cyclophosphamide, cyclosporine, amitriptyline, colchicine, cepharanthin, tacrolimus, dimethyl sulfoxide, vitamin D3 analogs, capsaicin, menthol, hydrocolloid dressings, surgical modalities, laser treatment, and phototherapy. CONCLUSION No definitive recommendation of preferable treatment procedures can be made based on the analyzed literature. Randomized controlled trials are needed to offer patients an evidence-based therapy with high-quality standardized treatment regimens for PLCA.
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Chu H, Shin JU, Lee J, Park CO, Lee KH. Successful treatment of lichen amyloidosis accompanied by atopic dermatitis by fractional CO2 laser. J COSMET LASER THER 2017; 19:345-346. [DOI: 10.1080/14764172.2017.1326612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Howard Chu
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jung U. Shin
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jungsoo Lee
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Ook Park
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang Hoon Lee
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
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