1
|
Guillet C, Steinmann S, Maul JT, Kolm I. Primary Localized Cutaneous Amyloidosis: A Retrospective Study of an Uncommon Skin Disease in the Largest Tertiary Care Center in Switzerland. Dermatology 2021; 238:579-586. [PMID: 34525472 DOI: 10.1159/000518948] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/04/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Primary localized cutaneous amyloidosis (PLCA) is defined by the deposition of amyloid protein in the skin without systemic involvement. There are four subtypes of PLCA: lichen amyloidosis (LA), macular amyloidosis (MA), biphasic amyloidosis (BA), and nodular amyloidosis (NA). PLCA occurs most frequently in Latin Americans and Asians. Treatment is not standardized. OBJECTIVES To identify subtypes, demographic and clinical features and treatment efficacy in patients with histopathologically confirmed PLCA. MATERIALS AND METHODS Data of PLCA patients were extracted from the electronic hospital database and included if diagnosis of PLCA was histopathologically confirmed and if sufficient information regarding treatment and follow-up was available. The evaluation of the treatment efficacy was based on a novel score to assess the reduction of itch and skin lesions. RESULTS In this retrospective, monocentric study, 37 cases of PLCA diagnosed between 2000 and 2020 were included (21 females) with a mean age of 52 years. LA was the most frequent subtype found in 21 patients (56.8%), followed by MA in 10 patients (28%) and BA in 6 patients (16.2%). No cases of NA were included. 22 patients (59.4%) had skin phototype II or III. Regarding treatment, a combination of UVA1 phototherapy with high-potency topical corticosteroids seemed to show the highest efficacy with complete clearance of symptoms in 4 patients (10.8%). A substantial improvement of symptoms was found in 5 patients (12.7%) treated with high-potency topical corticosteroids alone or in combination either with UVA1 or bath PUVA or monotherapy with UVA1 phototherapy or capsaicin (0.075%) cream. Low-/medium-potency topical corticosteroids alone or in combination with UVBnb (311 nm) phototherapy showed a lower efficacy. CONCLUSION Our data show that PCLA is a rare disease in central Europe but can also be expected in a predominantly Caucasian population. The best treatment response was achieved with a combination of UVA1 phototherapy and high-potency topical corticosteroids.
Collapse
Affiliation(s)
- Carole Guillet
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,Dermatological Allergology, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Simona Steinmann
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Julia-Tatjana Maul
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Isabel Kolm
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| |
Collapse
|
2
|
Piccolo V, Corneli P, Del Rosario Ossola M, Russo T, Ronchi A, Zalaudek I, Argenziano G. Macular amyloidosis and seronegative spondyloarthritis: Causal or casual association? Australas J Dermatol 2019; 60:e248-e249. [PMID: 30868580 DOI: 10.1111/ajd.13017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Paola Corneli
- Department of Dermatology, Ospedale Maggiore, University of Trieste, Trieste, Italy
| | | | - Teresa Russo
- Dermatology Unit, University of Campania, Naples, Italy
| | - Andrea Ronchi
- Anatomic pathology Unit, University of Campania, Naples, Italy
| | - Iris Zalaudek
- Department of Dermatology, Ospedale Maggiore, University of Trieste, Trieste, Italy
| | | |
Collapse
|
3
|
Velasco-Tamariz V, Burillo-Martínez S, Prieto-Barrios M, Calleja-Algarra A, Rodríguez-Peralto JL, Ortiz-Romero PL. Widespread biphasic amyloidosis related to ipilimumab treatment for metastatic melanoma. Int J Dermatol 2017; 56:e189-e191. [PMID: 28500627 DOI: 10.1111/ijd.13642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 03/23/2017] [Accepted: 03/27/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Virginia Velasco-Tamariz
- Department of Dermatology, Hospital 12 de Octubre and i+12 Medical School, Universidad Complutense, Madrid, Spain
| | - Sara Burillo-Martínez
- Department of Dermatology, Hospital 12 de Octubre and i+12 Medical School, Universidad Complutense, Madrid, Spain
| | - Marta Prieto-Barrios
- Department of Dermatology, Hospital 12 de Octubre and i+12 Medical School, Universidad Complutense, Madrid, Spain
| | - Alba Calleja-Algarra
- Department of Dermatology, Hospital 12 de Octubre and i+12 Medical School, Universidad Complutense, Madrid, Spain
| | - José L Rodríguez-Peralto
- Department of Pathology, Hospital 12 de Octubre, and i+12 Medical School, Universidad Complutense, Madrid, Spain
| | - Pablo L Ortiz-Romero
- Department of Dermatology, Hospital 12 de Octubre and i+12 Medical School, Universidad Complutense, Madrid, Spain
| |
Collapse
|
4
|
Generalized lichen amyloidosis and hyperthyroidism: coincidence or association. Postepy Dermatol Alergol 2013; 30:265-7. [PMID: 24278086 PMCID: PMC3834705 DOI: 10.5114/pdia.2013.37039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 06/18/2013] [Accepted: 06/23/2013] [Indexed: 11/17/2022] Open
Abstract
A 76-year-old white man presented with severe pruritic eruption on both of the extremities and lumbar area for 2 years. The dermatological examination showed multiple, 1-2 mm sized, hyperpigmented and hyperkeratotic papules which coalesced to form poorly delineated plaques spread on the lumbosacral area, lateral and extensor surfaces of thighs, arms and forearms. The histopathological examination revealed eosinophilic amorphous material in papillary dermis that was stained positively with crystal violet stain. The patient was diagnosed as generalized lichen amyloidosis (LA) clinically and histopathologically. Routine laboratory tests were within normal limits except thyroid function tests. The thyroid stimulating hormone level was decreased, while the thyroxine level was increased. Ultrasonography showed enlarged and heterogeneous thyroid gland. Thyroid autoantibodies were within normal limits. An association between LA and other diseases such as atopic dermatitis, lichen planus, mycosis fungoides, chronic urticaria, HIV infection, multiple endocrine neoplasia type 2A, and angiolymphoid hyperplasia with eosinophilia have been defined. However, there is no reported LA case associated with hyperthyroidism in the literature. We think that the same etiologic factor might have triggered both diseases, or hyperthyroidism, by causing the itching, might have induced the occurrence or spread of LA.
Collapse
|
5
|
Tanaka A, Arita K, Lai-Cheong JE, Palisson F, Hide M, McGrath JA. New insight into mechanisms of pruritus from molecular studies on familial primary localized cutaneous amyloidosis. Br J Dermatol 2009; 161:1217-24. [PMID: 19663869 DOI: 10.1111/j.1365-2133.2009.09311.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Macular and lichen amyloidosis are common variants of primary localized cutaneous amyloidosis (PLCA) in which clinical features of pruritus and skin scratching are associated with histological findings of deposits of amyloid staining on keratinous debris in the papillary dermis. Most cases are sporadic, but an autosomal dominant family history may be present in up to 10% of cases, consistent with a genetic predisposition in some individuals. Familial PLCA has been mapped to a locus on 5p13.1-q11.2 and in 2008 pathogenic heterozygous missense mutations were identified in the OSMR gene, which encodes oncostatin M receptor beta (OSMRbeta), an interleukin (IL)-6 family cytokine receptor. OSMRbeta is expressed in various cell types, including keratinocytes, cutaneous nerves and nociceptive neurones in dorsal root ganglia; its ligands are oncostatin M and IL-31. All pathogenic mutations are clustered in the fibronectin-III repeat domains of the extracellular part of OSMRbeta, sites that are critical for receptor dimerization (with either gp130 or IL-31RA), and lead to defective signalling through Janus kinase-signal transducers and activators of transcription, extracellular signal-regulated protein kinase 1/2 and phosphoinositide 3 kinase/Akt pathways. Elucidating the molecular pathology of familial PLCA provides new insight into mechanisms of pruritus in human skin, findings that may have relevance to developing novel treatments for skin itching. This review provides a clinicopathological and molecular update on familial PLCA.
Collapse
Affiliation(s)
- A Tanaka
- St John's Institute of Dermatology, King's College London (Guy's Campus), London, U.K
| | | | | | | | | | | |
Collapse
|
6
|
Dahdah MJ, Kurban M, Kibbi AG, Ghosn S. Primary localized cutaneous amyloidosis: a sign of immune dysregulation? Int J Dermatol 2009; 48:419-21. [DOI: 10.1111/j.1365-4632.2009.03799.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
7
|
|
8
|
|
9
|
Apaydin R, Gürbüz Y, Bayramgürler D, Müezzinoglu B, Bilen N. Cytokeratin expression in lichen amyloidosus and macular amyloidosis. J Eur Acad Dermatol Venereol 2004; 18:305-9. [PMID: 15096140 DOI: 10.1111/j.1468-3083.2004.00905.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To understand the role of epidermal cells in the pathogenesis of lichen amyloidosus (LA) and macular amyloidosis (MA). METHODS We carried out immunohistochemical investigations on cytokeratins (CKs) in amyloid deposits in formalin-fixed and paraffin-embedded tissue specimens from eight persons with LA and 12 with MA. The primary antibodies of CK1-8 (AE3), CK10 (DEK-10), CK14 (LL002), CK17 (E3), CK18 (DC10), CK19 (KS19.1), CK5/6/18 (LP34) and CK8/18 (5D3) were used in the study. RESULTS In amyloid deposits, immunoreactivity with only two monoclonal antibodies (CK1-8 and CK5/6/18) was observed in 14 cases (eight LA and six MA), confirming the hypothesis that epidermal cells participate in amyloid formation of LA and MA. COMMENTS All of the CKs detected in amyloid deposits were basic type (type II). It seems plausible either that acidic CKs might be degraded faster than basic types in amyloidogenesis or that paraffin-embedded tissue specimens are less sensitive than frozen tissue sections. The results of our study suggest that when paraffin-embedded specimens are investigated by immunohistochemical methods, CK5 antibody is useful in the diagnosis of LA and MA.
Collapse
Affiliation(s)
- R Apaydin
- Department of Dermatology, Medical Faculty, Kocaeli University, 41 900 Kocaeli, Turkey
| | | | | | | | | |
Collapse
|
10
|
Affiliation(s)
- Umit Tursen
- Department of Dermatology and of Pathology, Faculty of Medicine, Mersin University, Mersin, Turkey.
| | | | | | | |
Collapse
|
11
|
Ai J, Leonhardt JM, Heymann WR. Autoimmune thyroid diseases: etiology, pathogenesis, and dermatologic manifestations. J Am Acad Dermatol 2003; 48:641-59; quiz 660-2. [PMID: 12734493 DOI: 10.1067/mjd.2003.257] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Autoimmune thyroid disease (AITD) including Graves' disease, Hashimoto's thyroiditis, and idiopathic hypothyroidism (atrophic Hashimoto's thyroiditis) is of vital concern to the dermatologist. This article reviews the cutaneous manifestations of Graves' disease and Hashimoto's thyroiditis. Recognition of dermatologic manifestations of AITD may alert practitioners to investigate for these disorders. The immune response involved in the pathogenesis of AITD is detailed. Current understanding of the role of genetic and environmental factors, antigens, and apoptosis are elaborated. The future holds exciting insight into the etiology, pathogenesis, and treatment of AITD.
Collapse
Affiliation(s)
- Julia Ai
- University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Camden, USA
| | | | | |
Collapse
|