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Lim B, Seth I, Cuomo R, Cameron A, Rozen WM. Cutaneous amyloidosis mimicking basal cell carcinoma: a case series and literature review. J Plast Reconstr Aesthet Surg 2024; 95:340-348. [PMID: 38959620 DOI: 10.1016/j.bjps.2024.06.010] [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: 01/20/2024] [Revised: 06/04/2024] [Accepted: 06/06/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Amyloidosis is characterized by extracellular amyloid protein deposition. When amyloidosis intersects with basal cell carcinoma (BCC), it introduces complex diagnostic challenges. This study explored the overlap between primary localized cutaneous amyloidosis (PLCA) and BCC, examining amyloid deposits in BCC, systemic amyloidosis risk in PLCA, and various treatment methods. METHODS Two case studies were discussed, followed by a literature review, in which PubMed, Web of Science, EMBASE, and the Cochrane Library databases were utilized. The search, covering studies from infinity up to January 2024, focused on "cutaneous amyloidosis," "basal cell carcinoma," and related terms. Articles in English detailing the clinical presentation, diagnostic methods, treatment, and outcomes of cutaneous amyloidosis mimicking BCC were included. Data extraction and synthesis were performed by two independent reviewers. CASE SERIES This study highlighted two cases exemplifying the complexity of diagnosing BCC and PLCA. The first case (a 64-year-old with a nodule on the cheek) and the second (a 67-year-old with a nodular lesion on the upper lip cheek) were initially suspected as BCC and were later identified as PLCA upon histopathological examination. DISCUSSION The diagnosis of amyloidosis within BCC nodules remains a diagnostic challenge. Although their coexistence is relatively prevalent, their local recurrence rates remain debatable. Various diagnostic and therapeutic approaches have been suggested, such as topical creams and phototherapy. However, none have garnered conclusive and consistent evidence to establish reliable clinical application. CONCLUSION The findings emphasized the importance of considering alternative pathologies in differential diagnoses. Future research should focus on understanding systemic amyloidosis risks and optimizing care for both conditions.
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Affiliation(s)
- Bryan Lim
- Department of Plastic Surgery, Peninsula Health, Melbourne, Victoria 3199, Australia.
| | - Ishith Seth
- Department of Plastic Surgery, Peninsula Health, Melbourne, Victoria 3199, Australia; Department of Plastic Surgery, Bendigo Hospital, Bendigo, Victoria 3500, Australia
| | - Roberto Cuomo
- Department of Medicine, Plastic Surgery and Neuroscience, University of Siena, Siena 53100, Italy
| | - Alex Cameron
- Department of Plastic Surgery, Bendigo Hospital, Bendigo, Victoria 3500, Australia
| | - Warren M Rozen
- Department of Plastic Surgery, Peninsula Health, Melbourne, Victoria 3199, Australia
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Ahuja R, Bharti P, Khaitan BK, Arava SK, Gupta V. Lichen Amyloidosis of the External Ear. Indian Dermatol Online J 2024; 15:526-527. [PMID: 38845670 PMCID: PMC11152482 DOI: 10.4103/idoj.idoj_378_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/18/2023] [Accepted: 07/26/2023] [Indexed: 06/09/2024] Open
Affiliation(s)
- Rhea Ahuja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Prashant Bharti
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Binod K. Khaitan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Sudheer K. Arava
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Mustonen T, Sivonen V, Atula S, Kiuru-Enari S, Sinkkonen ST. Hearing problems in patients with hereditary gelsolin amyloidosis. Orphanet J Rare Dis 2021; 16:448. [PMID: 34689817 PMCID: PMC8543933 DOI: 10.1186/s13023-021-02077-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/10/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Gelsolin amyloidosis (AGel amyloidosis) is a hereditary form of systemic amyloidosis featuring ophthalmological, neurological and cutaneous symptoms. Previous studies based mainly on patients' self-reporting have indicated that hearing impairment might also be related to the disease, considering the progressive cranial neuropathy characteristic for AGel amyloidosis. In order to deepen the knowledge of possible AGel amyloidosis-related hearing problems, a clinical study consisting of the Speech, Spatial and Qualities of Hearing Scale (SSQ) questionnaire, clinical examination, automated pure-tone audiometry and a speech-in-noise test was designed. RESULTS Of the total 46 patients included in the study, eighteen (39%) had self-reported hearing loss. The mean scores in the SSQ were 8.2, 8.3 and 8.6 for the Speech, Spatial and Qualities subscales, respectively. In audiometry, the mean pure tone average (PTA) was 17.1 (SD 12.2) and 17.1 (SD 12.3) dB HL for the right and left ears, respectively, with no difference to gender- and age-matched, otologically normal reference values. The average speech reception threshold in noise (SRT) was - 8.2 (SD 1.5) and - 8.0 (SD 1.7) dB SNR for the right and left ears, respectively, which did not differ from a control group with a comparable range in PTA thresholds. CONCLUSION Although a significant proportion of AGel amyloidosis patients experience subjective difficulties in hearing there seems to be no peripheral or central hearing impairment at least in patients up to the age of 60 years.
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Affiliation(s)
- Tuuli Mustonen
- Clinical Neurosciences, Neurology, Helsinki University Hospital and University of Helsinki, HYKS, Tornisairaala, Neupkl, Haartmaninkatu 4, 00029, Helsinki, Finland.
- Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Ville Sivonen
- Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Sari Atula
- Clinical Neurosciences, Neurology, Helsinki University Hospital and University of Helsinki, HYKS, Tornisairaala, Neupkl, Haartmaninkatu 4, 00029, Helsinki, Finland
| | - Sari Kiuru-Enari
- Clinical Neurosciences, Neurology, Helsinki University Hospital and University of Helsinki, HYKS, Tornisairaala, Neupkl, Haartmaninkatu 4, 00029, Helsinki, Finland
| | - Saku T Sinkkonen
- Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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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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Magliulo G, Vincentiis LD, Pace A, Visconti IC, Le Foche F, Riminucci M, Corsi A. Unilateral Isolated Primary Cutaneous Amyloidosis of the External Auditory Canal. J Int Adv Otol 2020; 16:467-469. [PMID: 33136030 DOI: 10.5152/iao.2020.7570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Isolated primary cutaneous amyloidosis (PCA) of the external ear is extremely rare. We describe the case of a 65-year-old woman presenting with itching within the left external auditory canal (EAC). Otoscopy revealed a 3 mm whitish lesion involving the cartilaginous portion of the left EAC. The lesion was excised. Histological and immunohistochemical features were consistent with keratinic amyloidosis. A clinical workup was negative for systemic amyloidosis. As far as we know, only nine cases of PCA exclusively involving the EAC have been reported. The frequent occurrence of itching in these patients and the keratinic nature of the amyloid support the role of chronic stimulation/irritation in the pathogenesis of isolated amyloidosis the EAC.
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Affiliation(s)
- Giuseppe Magliulo
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | | | - Annalisa Pace
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | | | - Francesco Le Foche
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Mara Riminucci
- Department of Molecular Medicine, Sapienza University of Rome, Italy
| | - Alessandro Corsi
- Department of Molecular Medicine, Sapienza University of Rome, Italy
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Tee LY, Tan SH, Rajaratnam R. Asymptomatic waxy brown papules in the auricular concha. Int J Dermatol 2020; 59:e347-e348. [DOI: 10.1111/ijd.15039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/01/2020] [Accepted: 06/10/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Louis Y. Tee
- Department of Dermatology Changi General Hospital Singapore Singapore
| | - Sze Hwa Tan
- Department of Laboratory Medicine Changi General Hospital Singapore Singapore
| | - Ratna Rajaratnam
- Department of Dermatology Changi General Hospital Singapore Singapore
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Shokri T, Liaw J, Isildak H. Unilateral Otorrhea and Mastoid Erosion. JAMA Otolaryngol Head Neck Surg 2018; 144:641-642. [PMID: 29931033 DOI: 10.1001/jamaoto.2018.1096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Tom Shokri
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, College of Medicine, Pennsylvania State University, Hershey
| | - Jeffrey Liaw
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, College of Medicine, Pennsylvania State University, Hershey
| | - Huseyin Isildak
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, College of Medicine, Pennsylvania State University, Hershey
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Abuawad YG, Uchiyama J, Kakizaki P, Valente NYS. Primary cutaneous amyloidosis of the auricular concha - case report. An Bras Dermatol 2017; 92:433-434. [PMID: 29186270 PMCID: PMC5514598 DOI: 10.1590/abd1806-4841.20175864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 05/15/2016] [Indexed: 11/22/2022] Open
Affiliation(s)
- Yasmin Gama Abuawad
- Dermatology Service at Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, SP, Brazil
| | - Juliana Uchiyama
- Dermatology Service at Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, SP, Brazil
| | - Priscila Kakizaki
- Dermatology Service at Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, SP, Brazil
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Ramos-Rodríguez C, González-López L, Romero-Aguilera G. [Primary cutaneous amyloidosis of the external ear: A peculiar, unusual and benign entity]. Med Clin (Barc) 2016; 146:e13-4. [PMID: 26433311 DOI: 10.1016/j.medcli.2015.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 07/19/2015] [Accepted: 07/21/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Claudia Ramos-Rodríguez
- Servicio de Anatomía Patológica, Hospital General Universitario de Ciudad Real, Ciudad Real, España.
| | - Lucía González-López
- Servicio de Anatomía Patológica, Hospital General Universitario de Ciudad Real, Ciudad Real, España
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