1Professor & HOD, Dept. of Dermatology, Adichunchanagiri Institute of Medical Sciences, BG Nagara, Karnataka
2Junior Resident, Dept. of Dermatology, Adichunchanagiri Institute of Medical Sciences, BG Nagara, Karnataka
3Associate Professor, Dept. of Dermatology, Adichunchanagiri Institute of Medical Sciences, BG Nagara, Karnataka
4Assisstant Professor, Dept. of Dermatology, Adichunchanagiri Institute of Medical Sciences, BG Nagara, Karnataka
*Corresponding Author: Email: monica.dukkipati@gmail.com
Online published on 14 June, 2017.
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.
To study the correlation of clinical, dermoscopic and histopathological features in patients with clinically suspected macular amyloidosis.
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.
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.
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%.
Clinically suspected macular amyloidosis; Rippled pattern; Central brown hub/white hub; Amyloid deposits; Apple green birefringence
