IP Indian Journal of Clinical and Experimental Dermatology


To study the correlation of clinical, dermoscopic and histopathological features of clinically suspected macular amyloidosis


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Author Details: BD Sathyanarayana, Monica Dukkipati, MR Swaroop, Yogesh D, Aneesa

Volume : 3

Issue : 1

Online ISSN : 2581-4729

Print ISSN : 2581-4710

Article First Page : 9

Article End Page : 13


Abstract

Background: Macular amyloidosis is a common acquired hyperpigmented disorder seen predominantly in women involving the extremities and upper back which is cosmetically displeasing and may amount to emotional stress. It clinically presents as ill-defined hyperpigmented macules which gradually coalesce to form symmetric patches with characteristic rippled pattern.
Objectives: To study the correlation of clinical, dermoscopic and histopathological features in patients with clinically suspected macular amyloidosis.
Materials & Methods: A total of 50 patients with clinically suspected macular amyloidosis were enrolled in this cross-sectional study. A detailed history, cutaneous examination and dermoscopic patterns were documented. A punch biopsy was taken from the site where dermoscopic examination was done and stained with a) Hematoxylin & Eosin examined under light microscope b) Congo red stain observed under polarized microscope for amyloid deposits.
Results: Out of 50 patients with clinically suspected macular amyloidosis, 41 were females and 9 were males with male to female ratio being 1:4.5. The age ranged between 20 to 49 years with mean age of 27.64 years. Pumice stone (42%) was the most common abrasive material used for bathing. Hyperpigmentation in rippled pattern (72%) was the commonest morphological pattern seen. Extensor aspect of the upper limbs and upper back (46%) were the commonest sites of involvement. On dermoscopy, majority revealed a central brown hub (38%)/ white hub (18%) with surrounding radiating streaks of pigmentation. Majority of patients (76%) on histopathological examination showed amyloid deposits which with Congo red stain showed apple-green birefringence under polarized microscope.
Conclusion: The correlation between clinical, dermoscopic and histopathological features was statistically significant (p<0.001). Both the sensitivity and specificity of diagnosis of macular amyloidosis with the use of dermoscopy in our study was 100%.

Keywords:
Clinically suspected macular amyloidosis; Rippled pattern; Central brown hub/ white hub; Amyloid deposits; Apple green birefringence.