Successful treatment of lichen amyloidosis using a CO₂surgical laser

Abstract

Lichen amyloidosis (LA) is a type of primary localized cutaneous amyloidosis characterized by multiple pruritic discrete hyperkeratotic papules with amyloid deposition in the papillary dermis. Two patients with LA had been treated with topical corticosteroids, but with no effect on the eruptions. The present authors then started treating the affected area by superficial ablation using a CO2 surgical laser (LASER 30C, Lumenis Inc., Yokneum, Israel) at a setting of 10-15 watts with a 0.12-second pulse duration, 0.36-second rest duration, and 5-mm laser spot size. The present authors treated the patients twice a month with the CO2 laser. The papules on the legs had flattened in both patients, with a great improvement in the severe itching after 6 months in Case 1 and after 10 months in Case 2. These cases indicate that the CO2 laser led to a good response in terms of the clinical manifestations, and may be useful for the treatment of LA.

Nodular Amyloidosis Derived From Keratinocytes

“…10,21,33 Pulsed dye and CO 2 laser vaporization have also been used, but with high rates of recurrence. [40][41][42] In conclusion, we report the first case of PCLNA derived from AK-type amyloid in a 60-year-old woman. 18 Because no previous case of PCLNA with AK-type amyloid has been reported, there is no therapeutic information available, although it may be similar to the AK-derived lichen and macular subtypes.…”

Primary localized cutaneous amyloidosis with lichen and poikiloderma-like lesions and an excellent response to systemic acitretin

“…1,3 The eruptions initially developed as papules on her face and spread gradually to the other locations. Some lesions on the forehead and bilateral parts of the malar region and cheeks (is this a repetition of the same idea?)…”

“…The patient experienced clear relief from pruritus and saw some improvement in the papules and plaques 6 months later, with mild mucocutaneous side effects (Figure 1). 1,3 Furthermore, 18 months later, (later was missing but presumably that is what was meant?) the case showed a remarkably good response to the medicine (Figure 1).…”

“…1 There are a variety of clinical phenotypes and treatment is often difficult, particularly when the disease is severe and extensive. In this study, we describe a rare case of PLCA with lichen and poikiloderma-like lesions and an excellent response to systemic acitretin.…”

Ultraviolet-A1 phototherapy in the treatment of primary diffuse cutaneous amyloidosis: an additional phototherapy regimen for cutaneous amyloidosis with review of treatment options

“…Fractional CO2 laser has been used to treat 25 patients affected by PCA with some benefit, using both superficial and deep modes of fractional laser (25). Two patients affected by lichen amyloidosis have been treated with CO2 surgical laser with good response especially for the pruritus, after a failed treatment with topical corticosteroids in both cases (26). Amitriptyline was effective in controlling itch in two cases of lichen amyloidosis, supporting the hypothesis that small-fiber neuropathy may play a role in the pathogenesis of itch in PCA (1).…”