Nodular Localized Cutaneous Amyloidosis Treatment & Management

Updated: Jul 06, 2020
  • Author: Nicholas V Nguyen, MD; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Medical Care

Various methods attempt to improve the appearance of the nodular localized cutaneous amyloidosis lesions, including topical and intralesional corticosteroids, cryotherapy, dermabrasion, [24] shaving, curettage and electrodesiccation, carbon dioxide laser, [25, 26, 27] and pulsed dye laser. [28] However, lesions frequently recur after treatment. Topical and intralesional corticosteroids and cryotherapy usually are not helpful. One attempt at cryotherapy produced pinpoint bleeding. 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. [29]  One patient responded to intralesional methotrexate. [30]

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. [31]

  • 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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