Lichen Amyloidosis Workup
- Author: Sultan Al-Khenaizan, MBBS, FRCP(C); Chief Editor: Dirk M Elston, MD more...
Procedures
A skin biopsy may be performed in lichen amyloidosis.
Histologic Findings
Many stains can demonstrate amyloid deposits in the skin. The best known is the Congo-red stain, which under polarizing light gives apple-green birefringence. Other stains include periodic acid-Schiff (PAS); methyl violet; crystal violet; various cotton dyes (eg, pagoda red, Sirius red); and the fluorescent dyes, thioflavin-T and Phorwhite BBU.
Amyloid deposits in lichen amyloidosis are found in the papillary dermis, usually at the tips of the dermal papillae. Lichen amyloidosis is distinguished from macular amyloidosis by the presence of marked epidermal changes, including hyperkeratosis and acanthosis.
Eanes ED, Glenner GG. X-ray diffraction studies on amyloid filaments. J Histochem Cytochem. Nov 1968;16(11):673-7. [Medline].
Bugalho MJ, Limbert E, Sobrinho LG, et al. A kindred with multiple endocrine neoplasia type 2A associated with pruritic skin lesions. Cancer. Dec 1 1992;70(11):2664-7. [Medline].
Chabre O, Labat F, Pinel N, Berthod F, Tarel V, Bachelot I. Cutaneous lesion associated with multiple endocrine neoplasia type 2A: lichen amyloidosis or notalgia paresthetica?. Henry Ford Hosp Med J. 1992;40(3-4):245-8. [Medline].
Gagel RF, Levy ML, Donovan DT, Alford BR, Wheeler T, Tschen JA. Multiple endocrine neoplasia type 2a associated with cutaneous lichen amyloidosis. Ann Intern Med. Nov 15 1989;111(10):802-6. [Medline].
Kousseff BG, Espinoza C, Zamore GA. Sipple syndrome with lichen amyloidosis as a paracrinopathy: pleiotropy, heterogeneity, or a contiguous gene?. J Am Acad Dermatol. Oct 1991;25(4):651-7. [Medline].
Kousseff BG. Multiple endocrine neoplasia 2 (MEN 2)/MEN 2A (Sipple syndrome). Dermatol Clin. Jan 1995;13(1):91-7. [Medline].
Nunziata V, di Giovanni G, Lettera AM, D'Armiento M, Mancini M. Cutaneous lichen amyloidosis associated with multiple endocrine neoplasia type 2A. Henry Ford Hosp Med J. 1989;37(3-4):144-6. [Medline].
Pacini F, Fugazzola L, Bevilacqua G, Viacava P, Nardini V, Martino E. Multiple endocrine neoplasia type 2A and cutaneous lichen amyloidosis: description of a new family. J Endocrinol Invest. Apr 1993;16(4):295-6. [Medline].
Robinson MF, Furst EJ, Nunziata V, et al. Characterization of the clinical features of five families with hereditary primary cutaneous lichen amyloidosis and multiple endocrine neoplasia type 2. Henry Ford Hosp Med J. 1992;40(3-4):249-52. [Medline].
Rothberg AE, Raymond VM, Gruber SB, Sisson J. Familial medullary thyroid carcinoma associated with cutaneous lichen amyloidosis. Thyroid. Jun 2009;19(6):651-5. [Medline].
Doutre MS, Beylot C, Couzigou P, Beraud C. Lichen amyloidosis in Alagille syndrome. Arch Dermatol. Oct 1991;127(10):1590-1. [Medline].
Maddison B, Namazi MR, Samuel LS, et al. Unexpected diminished innervation of epidermis and dermoepidermal junction in lichen amyloidosus. Br J Dermatol. Aug 2008;159(2):403-6. [Medline].
Apaydin R, Gurbuz Y, Bayramgurler D, Muezzinoglu B, Bilen N. Cytokeratin expression in lichen amyloidosus and macular amyloidosis. J Eur Acad Dermatol Venereol. May 2004;18(3):305-9. [Medline].
Weyers W, Weyers I, Bonczkowitz M, Diaz-Cascajo C, Schill WB. Lichen amyloidosus: a consequence of scratching. J Am Acad Dermatol. Dec 1997;37(6):923-8. [Medline].
Frolich M, Enk A, Diepgen TL, Weisshaar E. Successful treatment of therapy-resistant pruritus in lichen amyloidosis with menthol. Acta Derm Venereol. 2009;89(5):524-6. [Medline].
Castanedo-Cazares JP, Lepe V, Moncada B. Lichen amyloidosis improved by 0.1% topical tacrolimus. Dermatology. 2002;205(4):420-1. [Medline].
Hsieh SD, Yamamoto R, Saito K, et al. Amyloidosis presented with whitening and loss of hair which improved after dimethylsulfoxide (DMSO) treatment. Jpn J Med. Aug 1987;26(3):393-5. [Medline].
Lim KB, Tan SH, Tan KT. Lack of effect of dimethyl sulphoxide (DMSO) on amyloid deposits in lichen amyloidosis. Br J Dermatol. Sep 1988;119(3):409-10. [Medline].
Ozkaya-Bayazit E, Kavak A, Gungor H, Ozarmagan G. Intermittent use of topical dimethyl sulfoxide in macular and papular amyloidosis. Int J Dermatol. Dec 1998;37(12):949-54. [Medline].
Pandhi R, Kaur I, Kumar B. Lack of effect of dimethylsulphoxide in cutaneous amyloidosis. J Dermatolog Treat. Mar 2002;13(1):11-4. [Medline].
Aram H. Failure of etretinate (RO 10-9359) in lichen amyloidosus. Int J Dermatol. Apr 1986;25(3):206. [Medline].
David M, Ingber A, Ben-Chetrit A, Sandbank J, Sandbank M. Effect of etretinate on lichen amyloidosus. Dermatologica. 1987;175(6):302-3. [Medline].
Marschalko M, Daroczy J, Soos G. Etretinate for the treatment of lichen amyloidosis. Arch Dermatol. May 1988;124(5):657-9. [Medline].
Choi JY, Sippe J, Lee S. Acitretin for lichen amyloidosus. Australas J Dermatol. May 2008;49(2):109-13. [Medline].
Carlesimo M, Narcisi A, Orsini D, Mari E, Di Russo P, Arcese A, et al. A case of lichen amyloidosus treated with acitretin. Clin Ter. Mar-Apr 2011;162(2):e59-61. [Medline].
Sawamura D, Sato-Matsumura KC, Shibaki A, Akiyama M, Kikuchi T, Shimizu H. A case of lichen amyloidosis treated with pulsed dye laser. J Eur Acad Dermatol Venereol. Mar 2005;19(2):262-3. [Medline].
Parsi K, Kossard S. Thermosensitive lichen amyloidosis. Int J Dermatol. Dec 2004;43(12):925-8. [Medline].
Aoki M, Kawana S. Lichen amyloidosis of the auricular concha: successful treatment with electrodesiccation. J Dermatol. Feb 2009;36(2):116-7. [Medline].
Ostovari N, Mohtasham N, Oadras MS, Malekzad F. 532-nm and 1064-nm Q-switched Nd:YAG laser therapy for reduction of pigmentation in macular amyloidosis patches. J Eur Acad Dermatol Venereol. Apr 2008;22(4):442-6. [Medline].
Breathnach SM, Bhogal B, Dyck RF, De Beer FC, Black MM, Pepys MB. Immunohistochemical demonstration of amyloid P component in skin of normal subjects and patients with cutaneous amyloidosis. Br J Dermatol. Aug 1981;105(2):115-24. [Medline].
Breathnach SM, Melrose SM, Bhogal B, et al. Amyloid P component is located on elastic fibre microfibrils in normal human tissue. Nature. Oct 22 1981;293(5834):652-4. [Medline].
Eriksson S, Janciauskiene S, Merlini G. The putative role of alpha-1-antitrypsin in the disaggregation of amyloid lambda fibrils. J Intern Med. Feb 1995;237(2):143-9. [Medline].
Kuligowski ME, Chang A. Non-itchy lichen amyloidosus. Int J Dermatol. Oct 1992;31(10):747. [Medline].
Lambert WC. Cutaneous deposition disorders. In: Farmer ER, Hood AF, eds. Pathology of the Skin. Vol 432. Norwalk, Conn: Appleton & Lange; 1990:50.
Li JJ, McAdam KP. Human amyloid P component: an elastase inhibitor. Scand J Immunol. Sep 1984;20(3):219-26. [Medline].
Monfrecola G, Iandoli R, Bruno G, Martellotta D. Lichen amyloidosus: a new therapeutic approach. Acta Derm Venereol. 1985;65(5):453-5. [Medline].
Piette WW. Myeloma, paraproteinemias, and the skin. Med Clin North Am. Jan 1986;70(1):155-76. [Medline].
Ruzicka T, Donhauser G, Linke RP, Landthaler M, Bieber T. [Cutaneous amyloidoses]. Hautarzt. May 1990;41(5):245-55. [Medline].
Shirahama T, Cohen AS. High-resolution electron microscopic analysis of the amyloid fibril. J Cell Biol. Jun 1967;33(3):679-708. [Medline].
Touart DM, Sau P. Cutaneous deposition diseases. Part I. J Am Acad Dermatol. Aug 1998;39(2 Pt 1):149-71; quiz 172-4. [Medline].
Wang WJ. Clinical features of cutaneous amyloidoses. Clin Dermatol. Apr-Jun 1990;8(2):13-9. [Medline].
Wong CK. Lichen amyloidosus. A relatively common skin disorder in Taiwan. Arch Dermatol. Sep 1974;110(3):438-40. [Medline].

