• Vol. 29 No. 1, 105–107
  • 15 January 2000

Lichen Amyloidosus: A Bullous Variant



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Introduction: Lichen amyloidosus is a common skin disease seen among Asian patients.

Clinical Picture: Typical features range from macular hyperpigmentation to pruritic, lichenified, hyperpigmented papules. However, in this rare bullous variant of lichen amyloidosus, bullae and vesicles are present. Histopathologically, deposits of amyloid were seen in the papillary dermis, associated with an intraepidermal or subepidermal blister.

Treatment and Outcome: No good treatment so far, but pruritus can be relieved by topical steroid.

Conclusion: It is important to screen for systemic amyloidosis with the relevant investigations as it can present similarly with blistering eruptions, in which the prognosis would be grave.

Systemic amyloidosis, first reported in 1886, is characterised by deposits of amyloid in various organs including the skin, which may manifest as skin purpura, papules, nodules and occasionally bullae (termed bullous amyloidosis in the literature), predominantly distributed over the periorbital and intertriginous areas. In contrast, lichen amyloidosus is solely a cutaneous amyloidosis problem and is not associated with bullae formation except in two rare cases, and now we are reporting the third such case.

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