วันศุกร์ที่ 25 กันยายน พ.ศ. 2552

55. Lichen amyloidosis

หญิง 51 ปี ผื่นเรื้อรังมากกว่า 4 ปี รักษามาตลอดที่แขนและคอดีขึ้นแล้วแต่ที่ขา 2 ข้างยังไม่หาย ช่วย Dx และ Rx หน่อยจ้า
Lichen amyloidosis is a cutaneous condition characterized by the appearance of occasionally itchy lichenoid papules, typically appearing bilaterally on the shins [เป็นส่วนหนึ่งของ
primary cutaneous amyloidosis (PCA)
most common clinical variant, accounting
for 67% of cases.1 Other types of PCA include macular,
nodular, and anosacral amyloidosis. The underlying cause
of amyloid deposition is unknown. Injuries induced by
trauma or insect bites may cause the initial damage to the
epidermal keratinocytes.
Definite diagnosis: skin biopsy
Treatment is usually unsatisfactory
Reduction of friction, potent topical corticosteroids,
and keratolytic agents comprise the first-line treatment.
Occlusion may be required to enhance the efficacy of topical
treatments and prevent scratching. Systemic retinoid,
dermabrasion, and the use of a scalpel to scrape the upper
layer of the skin may also be helpful.2 Frequency-doubled
Nd:YAG laser treatment has recently been reported to
produce excellent results

2 ความคิดเห็น:

  1. lichen amyloidosis ชอบเป็นตรงแข้ง

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  2. lichen amyloid

    Medical Care
    Because of the growing appreciation of the importance of pruritus as the primary trigger for the deposition of amyloid, treatment modalities are directed toward the relief of pruritus
    1.Sedating antihistamines
    2.Topical and intralesional steroids are beneficial if combined with other modalities. Costanedo-Cazares et al reported improvement in LA using treatment with 0.1% topical tacrolimus ointment.


    Surgical Care
    Aggressive strategies proposed for the removal of amyloid include laser vaporization, dermabrasion, and excision of individual lesions. However, both the lesions and the pruritus usually promptly recur after these treatments.

    (from eMedicine; lichen amyloid)

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