Abstract
Primary cutaneous amyloidosis (PCA) is a condition characterized by tissue deposition of misfolded proteins. PCA can present in different forms, namely macular, lichen, and nodular amyloidosis. These lesions can be of cosmetic concern and are difficult to treat. Many therapeutic modalities have been suggested for the treatment of PCA, with variable efficacy, including topical and systemic medications, phototherapy, electrodessication, dermabrasion, cryosurgery, and lasers. Over the past decade, several studies have reported successful treatment of PCA with different types of lasers; however, a review of these studies has never been reported in the dermatologic literature. The aim of this study was to review the efficacy and safety of lasers in the treatment of PCA. A search of the National Library of Medicine’s PubMed Database was performed. Studies were considered for inclusion based on their relevance, and specific data were extracted from all included studies. Eleven studies, comprising 64 patients, were included in this review. Significant improvements were observed in macular and lichen amyloidosis patients treated with carbon dioxide laser in two studies, while a number of case series and case reports showed good results with other types of laser in the treatment of PCA. This review was limited by the lack of large double-blinded randomized controlled trials and the overall small sample size. Laser treatment is a promising option in the treatment of PCA. Future randomized controlled trials are needed to compare the efficacy of different types of lasers and to select the best parameters for different types of PCA.
Similar content being viewed by others
References
Merlini G, Seldin DC, Gertz MA (2011) Amyloidosis: pathogenesis and new therapeutic options. J Clin Oncol 29:1924–1933
Terushkin V, Boyd KP, Patel RR, McLellan B (2013) Primary localized cutaneous amyloidosis. Dermatol Online J 19:20711
Li WM (1990) Histopathology of primary cutaneous amyloidoses and systemic amyloidosis. Clin Dermatol 8:30–35
Nakjang YS, Sivayathorn A, Reungsinpinya S, Yutthanawiwat T (1982) Biphasic amyloidosis: a clinicopathological and histochemical study. Australas J Dermatol 23:82–86
Vijaya B, Dalal BS, Sunila, Manjunath GV (2012) Primary cutaneous amyloidosis: a clinic-pathological study with emphasis on polarized microscopy. Indian J Pathol Microbiol 55:170–174
Chuang YY, Lee DD, Lin CS, Chang YJ, Tanaka M, Chang YT, Liu HN (2012) Characteristic dermoscopic features of primary cutaneous amyloidosis: a study of 35 cases. Br J Dermatol 167:548–554
Brownstein MH, Helwig EB (1970) The cutaneous amyloidoses. I. Localized forms. Arch Dermatol 102:8–19
Northcutt AD, Vanover MJ (1985) Nodular cutaneous amyloidosis involving the vulva: case report and literature review. Arch Dermatol 121:518–521
Love WE, Miedler JD, Smith MK, Mostow EN, Cooper KD, Gilliam AC (2008) The spectrum of primary cutaneous nodular amyloidosis: two illustrative cases. J Am Acad Dermatol 58:S33–S35
MacDonald DM, Black MM, Ramnarain N (1977) Immunofluorescence studies in primary localized cutaneous amyloidosis. Br J Dermatol 96:635–641
Chapel TA, Birmingham DJ, Malinowski YE (1977) Nodular primary localized cutaneous amyloidosis. Arch Dermatol 113:1248–1249
Behr FD, Levine N, Bangert J (2001) Lichen amyloidosis associated with atopic dermatitis: clinical resolution with cyclosporine. Arch Dermatol 137:553–555
Nakai N, Ozawa A, Katoh N (2014) Nodular primary localized cutaneous amyloidosis in a patient with pulmonary sarcoidosis. Indian J Dermatol 59:307–308
Hashimoto K, Kumakiri M (1979) Colloid-amyloid bodies in PUVA-treated human psoriatic patients. J Invest Dermatol 72:70–80
Chang YT, Liu HN, Wong CK, Chow KC, Chen KY (1997) Detection of Epstein–Barr virus in primary cutaneous amyloidosis. Br J Dermatol 136:823–826
Khoo BP, Tay YK, Goh CL (1999) Calcipotriol ointment vs. betamethasone 17-valerate ointment in the treatment of lichen amyloidosis. Int J Dermatol 38:539–541
Jin AG, Por A, Wee LK, Kai CK, Leok GC (2001) Comparative study of phototherapy (UVB) vs. photochemotherapy (PUVA) vs topical steroids in the treatment of primary cutaneous lichen amyloidosis. Photodermatol Photoimmunol Photomed 17:42–43
Pandhi R, Kaur I, Kumar B (2002) Lack of effect of dimethylsulphoxide in cutaneous amyloidosis. J Dermatolog Treat 13(1):11–14
Krishna A, Nath B, Dhir GG, Kumari R, Budhiraja V, Singh K (2012) Study on epidemiology of cutaneous amyloidosis in Northern India and effectiveness of dimethyl sulphoxide in cutaneous amyloidosis. Indian J Dermatol Online J 3:182–186
Marschalkó M, Daróczy J, Soós G (1998) Etretinate for the treatment of lichen amyloidosis. Arch Dermatol 124:657–659
Aram H (1986) Failure of etretinate (RO 10–9359) in lichen amyloidosis. Int J Dermatol 25:206
Hernández-Núñez A, Daudén E, Moreno de Vega MJ, Fraga J, Aragüés M, Garcia-Díez A (2001) Widespread biphasic amyloidosis: response to acitretin. Clin Exp Dermatol 26:256–259
Das J, Gogoi RK (2003) Treatment of primary localized cutaneous amyloidosis with cyclophosphamide. Indian J Dermatol Venereol Leprol 69:163–164
Wong CK, Li WM (1982) Dermabrasion for lichen amyloidosus. Report of a long-term study. Arch Dermatol 118:302–304
Savant SS (1995) Therapeutic regional dermabrasion in papular lichen amyloidosis of shins. Indian J Dermatol Venereol Leprol 61:196–201
Fraunfelder FW (2009) Liquid nitrogen cryotherapy for conjunctival amyloidosis. Arch Ophthalmol 127:645–648
Chakraborti C, Chaudhury KP, Biswas RR (2014) Primary conjunctival amyloidosis. Oman J Ophthalmol 7:16–18
Aoki M, Kawana S (2009) Lichen amyloidosis of the auricular Concha: successful treatment with electrodessication. J Dermatol 36:116–117
Anitha B, Mysore V (2012) Lichen amyloidosis: novel treatment with fractional ablative 2, 940 nm erbium: YAG laser treatment. J Cutan Aesthet Surg 5:141–143
Ritchie SA, Beachkofsky T, Schreml S, Gaspari A, Hivnor CM (2014) Primary localized cutaneous nodular amyloidosis of the feet: a case report and review of the literature. Cutis 93:89–94
Kakani RS, Goldstein AE, Meisher I, Hoffman C (2001) Nodular amyloidosis: case report and literature review. J Cutan Med Surg 5:101–104
Esmat SM, Fawzi MM, Gawdat HI, Ali HS, Sayed SS (2015) Efficacy of different modes of fractional CO2 laser in the treatment of primary cutaneous amyloidosis: a randomized clinical trial. Lasers Surg Med 47:388–395
Ostovari N, Mohtasham N, Oadras MS, Malekzad F (2008) 532-nm and 1064-nm Q-switched Nd:YAG laser therapy for reduction of pigmentation in macular amyloidosis patches. J Eur Acad Dermatol Venereol 22:442–446
Panchaprateep R, Tusgate S, Munavalli GS, Noppakun N (2015) Fractional 1,550 nm ytterbium/erbium fiber laser in the treatment of lichen amyloidosis: clinical and histological study. Lasers Surg Med 47:222–230
Norisugi O, Yamakoshi T, Shimizu T (2014) Successful treatment of lichen amyloidosis using a CO2 surgical laser. Dermatol Ther 27:71–73
Barsky M, Buka RL (2014) Pulsed dye laser for the treatment of macular amyloidosis: a case report. Cutis 93:189–192
Lesiak A, Rakowski A, Brzezinska A, Rogowski-Tylman M, Kolano P, Sysa-Jedrzejowska A, Narbutt J (2012) Effective treatment of nodular amyloidosis with carbon dioxide laser. J Cutan Med Surg 16:372–374
Sawamura D, Sato-Matsumura KC, Shibaki A, Akiyama M, Kikuchi T, Shimizu H (2005) A case of lichen amyloidosis treated with pulsed dye laser. J Eur Acad Dermatol Venereol 19:262–263
Liu HT (2000) Treatment of lichen amyloidosis (LA) and disseminated superficial porokeratosis (DSP) with frequency-doubled Q-switched Nd:YAG laser. Dermatol Surg 26:958–962
Hamzavi I, Lui H (1999) Excess tissue friability during CO2 laser vaporization of nodular amyloidosis. Dermatol Surg 25:726–728
Alster TS, Manaloto RM (1999) Nodular amyloidosis treated with a pulsed dye laser. Dermatol Surg 25:133–135
Truhan AP, Garden JM, Roenigk HH Jr (1986) Nodular primary localized cutaneous amyloidosis: immunohistochemical evaluation and treatment with the carbon dioxide laser. J Am Acad Dermatol 14:1058–1062
Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR (2004) Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 34:426–438
Freedman JR, Greene RM, Green JB (2014) Histologic effects of resurfacing lasers. Facial Plast Surg 30:40–48
Hantash BM, Bedi VP, Sudireddy V, Struck SK, Herron GS, Chan KF (2006) Laser-induced transepidermal elimination of dermal content by fractional photothermolysis. J Biomed Opt 11:041115
Ortiz AE, Tremaine AM, Zachary CB (2010) Long-term efficacy of a fractional resurfacing device. Lasers Surg Med 42:168–170
Anderson RR, Parrish JA (1983) Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science 220:524–527
Alexis AF (2013) Lasers and light-based therapies in ethnic skin: treatment options and recommendations for Fitzpatrick skin types V and VI. Br J Dermatol 169:91–97
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
This study was not funded or supported by any sources.
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Al Yahya, R.S. Treatment of primary cutaneous amyloidosis with laser: a review of the literature. Lasers Med Sci 31, 1027–1035 (2016). https://doi.org/10.1007/s10103-016-1917-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10103-016-1917-8