10.5826/dpc.1203a133
text/xml
2160-9381
2050
en
Esteban Maronna
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Dermoscopy as a supportive tool to differentiate lichen amyloidosus from clinical mimickers
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2022-09-13
2021-09-17
2022-07-28
2022-09-15
e2022133
Dermatol Pract Concept
Esteban Maronna
2022/09/13
10.5826/dpc.1203a133
e2022133
Histopathology Department, Hospital F.J. Muñiz, Buenos Aires, Argentina
2160-9381
en
e2022133
Errichetti E, Stinco G. Dermoscopy for improving the diagnosis of pretibial pruritic papular dermatitis. Australas J Dermatol. 2018;59(1):e74-e75. DOI: 10.1111/ajd.12610.PMID: 28636138.
Dermoscopy as a supportive tool to differentiate lichen amyloidosus from clinical mimickers
https://dpcj.org/index.php/dpc/article/download/2050/1752
                    Dermatology Practical & Conceptual


   Dermoscopy as a Supportive Tool to Differentiate
     Lichen Amyloidosus From Clinical Mimickers
        Emilia N. Cohen Sabban1, Enzo Errichetti2, Horacio A. Cabo1, Esteban Maronna3


1 Dermatology Department “Instituto de Investigaciones Médicas A. Lanari”, University of Buenos Aires, Argentina
2 Institute of Dermatology, “Santa Maria della Misericordia” University Hospital, Udine, Italy
3 Histopathology Department, Hospital F.J. Muñiz, Buenos Aires, Argentina



Citation: Sabban ENC, Errichetti E, Cabo HA, Maronna E. Dermoscopy as a supportive tool to differentiate lichen amyloidosus from
clinical mimickers. Dermatol Pract Concept. 2022;12(3):e2022133. DOI: https://doi.org/10.5826/dpc.1203a133
Accepted: December 2, 2021; Published: July 2022
Copyright: ©2022 Sabban et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication
Corresponding author: Emilia N. Cohen Sabban, Dermatology Department “Instituto de Investigaciones Médicas A. Lanari”, University of
Buenos Aires, Argentina, E-mail: emicohensabban@gmail.com




Case Presentation                                                       Teaching point
A 52-year-old woman presented with a 5-year history of itchy            Dermoscopy may be of aid in recognizing lichen amyloidosis
hyperkeratotic brownish papules on the legs (Figure 1A) der-            by showing a peculiar pigmentary pattern resulting from the
moscopically typified by central brown globules surrounded              presence of melanin granules within amyloid deposition in
by a pigmented halo (Figure 1B). Histology showed compact               dermal papilla (central globule) and basal layer hyperpig-
ortho-hyperkeratosis, irregular acanthosis, and amorphous               mentation/dermal pigment incontinence (peripheral pigmen-
eosinophilic material in the upper dermis which displayed               tation) [1]. Indeed, such dermoscopic clues are different from
positive Congo red staining and a green fluorescence under              those visible in similar conditions, ie, pretibial pruritic pap-
polarized microscopy (Figure 1C), consistently with a diag-             ular dermatitis (dotted/globular vessels over a pinkish-white
nosis of lichen amyloidosis.                                            background) (Figure 1D), lichen myxedematous (white
                                                                        structureless areas) (Figure 1E), and lichen planus (Wickham
                                                                        striae) (Figures 1F) [1,2].




Image Letter | Dermatol Pract Concept. 2022;12(3):e2022133                                                                            1
    Figure 1. (A) Clinical examination shows hyperkeratotic brownish papules on the legs (better seen in the inset). (B) Dermoscopically
    characterized by central brown globules surrounded by a pigmented halo (magnification in the inset). (C) Histology (H&E; 100x)
    reveals compact orthohyperkeratosis, irregular acanthosis, and amorphous eosinophilic material in the upper dermis which is typified by
    a green fluorescence under polarized microscopy (inset). (D-F) Dermoscopic features of the main clinical mimickers of lichen amyloidosus,
    namely, pretibial pruritic papular dermatitis (dotted vessels over a pinkish-white background – magnification in the upper right inset) (D),
    lichen myxedematous (white structureless areas) (E), and lichen planus (Wickham striae) (F).




References                                                                   2. Errichetti E, Stinco G. Dermoscopy for improving the
                                                                                diagnosis of pretibial pruritic papular dermatitis. Australas J
1. Errichetti E, Lallas A. Other infiltrative conditions. In: Lallas A,         Dermatol. 2018;59(1):e74-e75. DOI: 10.1111/ajd.12610.
   Errichetti E, Ioannides D, eds. Dermoscopy in General Dermatol-              PMID: 28636138.
   ogy. 1st ed. Boca Raton, FL: CRC Press; 2018:2-46.




2                                                                                  Image Letter | Dermatol Pract Concept. 2022;12(3):e2022133
