Diffuse pigmentation of back and arms: macular amyloidosis or other?

  • Seyed Zahra Ghodsi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Pari Rahimi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Amir Ehsani Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Pedram Noormohammadpour Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Masood Asgrai Ackerman Academy of Dermatopathology, New York City, USA.
  • Fatemeh Gholamali Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Keywords:
Amyloid deposition, Anti-cytokeratin antibody, Macular amyloidosis, Pigmentation

Abstract

The study was undertaken to answer the question that how many patients with pigmentation of back and arms actually have amyloid deposits in pathology. 44 patients presenting with diffuse pigmentation of back and arms (DPOBA) were selected. Skin biopsies were performed in all cases from the affected sites. On all formalin fixed and paraffin embedded specimens, the following histochemical stains were performed: Haematoxylin and eosin (H&E), Congo red and immunohistochemical staining using anti-cytokeratin monoclonal antibody. In 9 of 44 cases (20%), amyloid deposits were found. In the remaining 35 cases (80%), H&E, Congo red and immunohistochemical staining failed to show any amyloid deposition. We were unable to find amyloid deposition in most of the patients presented with DPOBA. It seems that the signs may be attributable other disorders with similar clinical but different pathophysiologic aspects.

References

Rasi A, Khatami A, Javaheri SM. Macular amyloidosis: an assessment of prevalence, sex, and age. Int J Dermatol 2004;43(12):898-9.

Siragusa M, Ferri R, Cavallari V, Schepis C. Friction melanosis, friction amyloidosis, macular amyloidosis, towel melanosis: many names for the same clinical entity.Eur J Dermatol 2001;11(6):545-8.

Sarkany R.P.E , Breathnach SM, Seymour C.A, et al. Metabolic and Nurtiotional Disorders. In: Burns T,Breathnach S, Cox N, et al. Rook’s Textbook of Dermatology, 7th edition. Blackwell Scientific Publication. 2004:57;36-51.

Martin M. Black, Edward Upjohn, Sandra Albert. Amyloidosis. In: Jean L, Bolognia, Joseph L, Jorizzo, Ronald P, Rapini. Dermatology. Mosby 2008: 623-631.

Taheri R. Prevalence of macular amyloidosis in north Iran. Indian J Dermatol 2007;52:192-3.

Cheung ST, Maheshwari MB, Tan CY. A comparative study of two Congo red stains for the detection of primary cutaneous amyloidosis. J Am Acad Dermatol 2006;55(2):363-4.

Eto H, Hashimoto K, Kobayashi H, Fukaya T, Matsumoto M, Sun TT. Differential staining of cytoid bodies and skinlimited amyloids with monoclonal anti-keratin antibodies. Am J Pathol 1984;116(3):473-8.

Yoneda K, Watanabe H, Yanagihara M, Mori S. Immunohistochemical staining properties of amyloids with anti-keratin antibodies using formalin-fixed, paraffinembedded sections. J Cutan Pathol 1989;16(3):133-6.

Inoue K, Takahashi M, Hamamoto Y, Muto M, Ishihara T. An immunohistochemical study of cytokeratins in skinlimited amyloidosis. Amyloid 2000;7(4):259-65.

Masu S, Hosokawa M, Seiji M. Amyloid in localized cutaneous amyloidosis: immunofluorescence studies with anti-keratin antiserum especially concerning the difference between systemic and localized cutaneous amyloidosis. Acta Derm Venereol 1981;61(5):381-4.

Apaydin R, Gürbüz Y, Bayramgürler D, Müezzinoglu B, Bilen N. Cytokeratin expression in lichen amyloidosus and macular amyloidosis. J Eur Acad Dermatol Venereol 2004;18(3):305-9.

Looi LM. Primary localized cutaneous amyloidosis in Malaysians. Australas J Dermatol 1991;32(1):39-4.

How to Cite
1.
Ghodsi SZ, Rahimi P, Ehsani A, Noormohammadpour P, Asgrai M, Gholamali F. Diffuse pigmentation of back and arms: macular amyloidosis or other?. Acta Med Iran. 51(5):329-333.
Section
Articles