Abstract
The patient was a 56-year-old female. The whole body has brown patches for 16 years. Dermatological examination: brown patches were observed on the trunk and lower limbs, with scattered hypomigmentation patches and symmetrical distribution of skin lesions. Histopathology of the skin showed mild hyperkeratosis in the epidermis, focal liquefaction degeneration in the basal layer, masses of light red stained material in the dermal papilla, scattered or small patches of lymphocytes and tissue cell infiltration around capillaries in the superficial dermis, more pigmentophagocytes and positive methyl violet staining were observed. Diagnosis: cutaneous amyloidosis with abnormal pigmentation. The patient is still being followed up.
Highlights
The 56-year-old female patient has presented brown patches all over her body for 16 years
The cutaneous histopathology revealed slight epidermis hyperkeratosis, focal liquefied degeneration in the basal layer, crumby reddish matters in papillare cutis, scattered or small strips of lymphocytes and macrophages infiltration around capillary vessels in the superficial dermis, and more chromophagocytic cells (Figure 2a); the methyl violet staining results are positive (Figure 2b); Diagnosis: the patient was diagnosed with amyloidosis cutis dyschromica (ACD)
Its clinical features include that [2]: (1) It often attacks the preadolescents, some of whom have family history; (2) Most patients are Asians, such as Chinese, Japanese and Thai people; (3) Skin lesions show reticulate acropigmentation accompanied by spotted hypopigmentation; (4) There are no obvious subjective symptoms, such as itch or occasionally slight itch; (5) Pigment changes almost affect the skin of the whole body, but the skin of the face, neck and hands are lighter than the non-exposed parts
Summary
The 56-year-old female patient has presented brown patches all over her body for 16 years. According to the skin check, visible brown patches were found on the trunk and both lower limbs, on which there were scattered hypopigmented macules partially fused and with different diameters in the form of atrophic round white spots (Figures 1a and 1b). The cutaneous histopathology revealed slight epidermis hyperkeratosis, focal liquefied degeneration in the basal layer, crumby reddish matters in papillare cutis, scattered or small strips of lymphocytes and macrophages infiltration around capillary vessels in the superficial dermis, and more chromophagocytic cells (Figure 2a); the methyl violet staining results are positive (Figure 2b); Diagnosis: the patient was diagnosed with amyloidosis cutis dyschromica (ACD). Figure 2a: slight epidermis hyperkeratosis, focal liquefied degeneration in the basal layer, crumby reddish matters in papillare cutis, scattered or small strips of lymphocytes and macrophages infiltration around capillary vessels in the superficial dermis, more chromophagocytic cells (HE,200×)
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