Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.
Br J Dermatol. 2012 Sep;167(3):548-54. doi: 10.1111/j.1365-2133.2012.11066.x.
Primary cutaneous amyloidosis (PCA) is a relatively common skin disorder among Asians and South Americans. It is usually diagnosed clinically. However, for cases with atypical presentations, the diagnosis can be a challenge and skin biopsy may be necessary. Dermoscopy has been proved to be a valuable, noninvasive tool in the diagnosis of cutaneous pigmented diseases. Most lesions of PCA show hyperpigmentation and the major histopathological abnormalities of PCA occur in the epidermis and dermal papillae. Dermoscopy might be a powerful tool to provide valuable information for the diagnosis of PCA.
We aimed to find characteristic dermoscopic features of PCA.
Cases with typical clinical presentations of PCA, either macular or lichen subtypes, were included in this study. All were evaluated using a hand-held, polarized and nonpolarized dermoscope.
A total of 35 patients with clinically diagnosed PCA were enrolled. Eighteen patients had lesions consistent with macular amyloidosis and 17 with lichen amyloidosus. We found two major dermoscopic patterns characteristic of PCA. The most common dermoscopic finding of PCA was a central hub, which could be either white or brown, surrounded by various configurations of pigmentation. For cases of lichen amyloidosus with prominent hyperkeratosis, the central hub was replaced by a scar-like morphology.
This is the first study to report the characteristic dermoscopic features of PCA. We demonstrate that the use of a dermoscope may assist in achieving an accurate diagnosis of PCA.
原发性皮肤淀粉样变性（PCA）是亚洲人和南美人中较为常见的皮肤疾病。通常通过临床诊断。然而，对于表现不典型的病例，诊断可能具有挑战性，可能需要进行皮肤活检。皮肤镜已被证明是诊断皮肤色素性疾病的一种有价值的、非侵入性工具。大多数 PCA 病变表现为色素沉着，PCA 的主要组织病理学异常发生在表皮和真皮乳头。皮肤镜可能是提供 PCA 诊断有价值信息的有力工具。
我们旨在寻找 PCA 的特征性皮肤镜特征。
本研究纳入了具有典型 PCA 临床表现（斑片状或苔藓样亚型）的病例。所有病例均使用手持式偏振和非偏振皮肤镜进行评估。
共纳入 35 例临床诊断为 PCA 的患者。18 例病变符合斑状淀粉样变性，17 例符合苔藓样淀粉样变性。我们发现了两个 PCA 的主要皮肤镜特征。PCA 最常见的皮肤镜表现是中央结节，可为白色或棕色，周围有各种色素沉着模式。对于伴有明显角化过度的苔藓样淀粉样变性，中央结节被瘢痕样形态取代。
这是第一项报告 PCA 特征性皮肤镜特征的研究。我们证明使用皮肤镜可能有助于准确诊断 PCA。
