Background. A 26-year-old male presented with a 3-year history of lichen am yloidosis. On examination, there was a pigmented papular eruption with a ripple pattern affecting the limbsandtrunkbutsparingtheaxillae,antec...Background. A 26-year-old male presented with a 3-year history of lichen am yloidosis. On examination, there was a pigmented papular eruption with a ripple pattern affecting the limbsandtrunkbutsparingtheaxillae,antecubitalandpopliteal fossae, central chest, neck and face. There was also prominent sparing of the sk in overlying the superficial veins of the limbs. The sparing of the superficial veins of the limbs by lichen amyloidosis raised the possible role of cutaneous t emperature in governing the distribution of amyloid deposits in our patient. Obs ervations. Total body infrared thermography demonstrated consistent sparing of t he amyloid deposits in areas with higher cutaneous temperatures such as the neck and axillae as well as the course of the superficial veins. The cooler areas su ch as the extensor surfaces of the arms and legs corresponded to areas of amyloi d deposition. Narrow band ultraviolet B (NBUVB) phototherapy over a 5-month per iod resulted in a marked improvement of pruritus and clearing of the amyloid dep osits. Conclusions. Our patient clearly demonstrated lichen amyloidosis in a the rmosensitive distribution. This may be a gross manifestation of previous reports of in vitro thermosensitivity of amyloid fibril formation and may have potentia l implications in treatment at least in a subset of patients demonstrating this clinical feature.展开更多
文摘Background. A 26-year-old male presented with a 3-year history of lichen am yloidosis. On examination, there was a pigmented papular eruption with a ripple pattern affecting the limbsandtrunkbutsparingtheaxillae,antecubitalandpopliteal fossae, central chest, neck and face. There was also prominent sparing of the sk in overlying the superficial veins of the limbs. The sparing of the superficial veins of the limbs by lichen amyloidosis raised the possible role of cutaneous t emperature in governing the distribution of amyloid deposits in our patient. Obs ervations. Total body infrared thermography demonstrated consistent sparing of t he amyloid deposits in areas with higher cutaneous temperatures such as the neck and axillae as well as the course of the superficial veins. The cooler areas su ch as the extensor surfaces of the arms and legs corresponded to areas of amyloi d deposition. Narrow band ultraviolet B (NBUVB) phototherapy over a 5-month per iod resulted in a marked improvement of pruritus and clearing of the amyloid dep osits. Conclusions. Our patient clearly demonstrated lichen amyloidosis in a the rmosensitive distribution. This may be a gross manifestation of previous reports of in vitro thermosensitivity of amyloid fibril formation and may have potentia l implications in treatment at least in a subset of patients demonstrating this clinical feature.
