Bergis M, Dega H, Planquois V, Benichou O, Dubertret L
Service de Dermatologie I, Hôpital Saint-Louis, Paris.
Ann Dermatol Venereol. 2003 Nov;130(11):1039-42.
Secondary AA amyloidosis is a classical complication of rheumatismal or chronic infectious diseases. Psoriasis is a rare cause of secondary amyloidosis with only around thirty cases reported in the literature.
A 62 year-old man exhibited cutaneous lesions of psoriasis for six years complicated by articular involvement over the past year. The occurrence of an isolated proteinuria revealed renal and hepatic AA amyloidosis. Treatment with methotrexate (Méthrotrexate), enalapril (Renitec) and colchicine (Colchicine) was initiated and led to a stabilization of the proteinuria for two years.
In psoriatic patients, secondary amyloidosis mainly complicates the arthritic diseases of prolonged progression. Our case report is original in the rapid onset of amyloidosis after the first articular signs. The clinical manifestations of secondary amyloidosis are related to renal or gastrointestinal involvement. Prognosis is usually poor. Treatment of secondary amyloidosis is difficult and relies on systemic treatment. Colchicine may be helpful.
继发性AA型淀粉样变性是风湿性或慢性感染性疾病的经典并发症。银屑病是继发性淀粉样变性的罕见病因，文献中仅报道了约30例病例。
一名62岁男性有六年的银屑病皮肤病变，在过去一年中并发关节受累。孤立性蛋白尿的出现提示肾和肝AA型淀粉样变性。开始用甲氨蝶呤（Méthrotrexate）、依那普利（Renitec）和秋水仙碱（Colchicine）治疗，蛋白尿稳定了两年。
在银屑病患者中，继发性淀粉样变性主要使病程延长的关节炎疾病复杂化。我们的病例报告的独特之处在于在首次出现关节症状后淀粉样变性迅速发作。继发性淀粉样变性的临床表现与肾脏或胃肠道受累有关。预后通常较差。继发性淀粉样变性的治疗困难，依赖于全身治疗。秋水仙碱可能有帮助。
