Lichen Amyloidosis

September 7, 2012
Ted Rosen, MD

This is the most common form of amyloid deposition in the skin. It is not associated with the systemic disease, but is solely a cutaneous malady.

A 57-year-old man presents for evaluation of an intensely itchy eruption involving both forelegs. He is ostensibly in good health and denies medication use.

Key point: This is a distinctly unique presentation consisting of close-set, monomophous, red-brown papules with slight scale, located on the shins. The diagnosis is almost always lichen amyloidosis, a form of primary cutaneous amyloid. Itching is typically severe.

Treatment: There is no specific therapy. Oral antihistamines may be sufficient to relieve itching. UVA and UVB phototherapy may also help alleviate itching, although the papules will persist.

Note: This is the most common form of amyloid deposition in the skin. It is NOT associated with systemic disease, but is solely a cutaneous malady. Lichen amyloid is more common in late middle age (50 to 60 years) and in men.

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