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Nodular Localized Cutaneous Amyloidosis Treatment & Management

  • Author: Nicholas V Nguyen, MD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Nov 10, 2014
 

Medical Care

Various methods attempt to improve the appearance of the nodular localized cutaneous amyloidosis lesions, including topical and intralesional corticosteroids, cryotherapy, dermabrasion,[21] shaving, curettage and electrodesiccation, carbon dioxide laser,[22, 23, 24] and pulsed dye laser.[25] However, lesions frequently recur after treatment. Topical and intralesional corticosteroids and cryotherapy usually are not helpful. One attempt at cryotherapy produced pinpoint bleeding. Recently, a solitary report has described successful treatment with cyclophosphamide in a patient with both CREST (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) and Sjögren syndrome.[26]

Rarely, patients with nodular localized cutaneous amyloidosis develop systemic amyloidosis or multiple myeloma years later, suggesting the need for follow-up care.

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Surgical Care

Procedures may include the following:

  • Procedures such as excision and curettage and electrodessication have provided satisfactory cosmetic results for nodular localized cutaneous amyloidosis.[27]
  • Laser treatment has been described in nodular localized cutaneous amyloidosis.
  • Excessive tissue friability and difficulty with intraoperative hemostasis were described while treating one nasal lesion with carbon dioxide laser; however, a good cosmetic result was achieved.
  • A patient treated with a tunable dye laser had a good result, and clinical improvement was maintained over 6 months.

None of these treatment methods totally eradicates lesions, which can recur.

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Contributor Information and Disclosures
Author

Nicholas V Nguyen, MD Resident Physician, Department of Dermatology, Children's Hospital Colorado, Denver Health Medical Center, University of Colorado Hospital, VA Eastern Colorado

Nicholas V Nguyen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, International Society of Dermatology, Society for Pediatric Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Tracy Funk, MD Fellow in Pediatric Dermatology, Department of Dermatology, The Children’s Hospital Colorado

Tracy Funk, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Academy of Pediatrics, Society for Pediatric Dermatology, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Warren R Heymann, MD Head, Division of Dermatology, Professor, Department of Internal Medicine, Rutgers New Jersey Medical School

Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Catharine Lisa Kauffman, MD, FACP Georgetown Dermatology and Georgetown Dermpath

Catharine Lisa Kauffman, MD, FACP is a member of the following medical societies: American Academy of Dermatology, Royal Society of Medicine, Women's Dermatologic Society, American Medical Association, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

Lauren Biesbroeck Washington University in St Louis School of Medicine

Disclosure: Nothing to disclose. Marion C Miethke, MD Clinical Assistant Professor, Department of Internal Medicine, Section of Dermatology, University of Washington

Disclosure: Nothing to disclose.

Gregory J Raugi, MD, PhD Professor, Department of Internal Medicine, Division of Dermatology, University of Washington at Seattle School of Medicine; Chief, Dermatology Section, Primary and Specialty Care Service, Veterans Administration Medical Center of Seattle

Gregory J Raugi, MD, PhD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

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The bright pink homogeneous-appearing material seen is amyloid stained with Congo red. A distinguishing feature of amyloid in the skin is an affinity to take up Congo red stain.
Amyloid shows apple green when examined with polarized light.
This transmission electron micrograph of amyloid deposited in the tissue shows loosely interwoven straight filaments.
 
 
 
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