Treatment of lichen amyloidosis with fractional CO 2 laser and topical steroid: a preliminary study of 10 cases
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BRIEF REPORT
Treatment of lichen amyloidosis with fractional CO2 laser and topical steroid: a preliminary study of 10 cases Meiling Wang 1 & Yan Lin 1 & Weizhi Wu 1 & Yongmei Yu 1 & Xiaodong Liu 1 & Xiaoyuan Gao 1 & Huaxu Liu 1 Received: 11 September 2020 / Accepted: 3 November 2020 # Springer-Verlag London Ltd., part of Springer Nature 2020
Introduction The primary localized cutaneous amyloidosis (PLCA) is characterized by the extracellular deposition of amyloid proteins in previously normal skin without systematic involvement [1]. The main subtypes of PLCA have been identified, which comprises lichen amyloidosis (LA), macular amyloidosis (MA), and nodular amyloidosis (NA). Additionally, the combined appearance of different subtypes will occur [2, 3]. Lichen amyloidosis (LA), the most common form of PLCA, presents with localized or rarely generalized, hyperpigmented macules or papules, which is usually located on the shins, calves, dorsal feet, forearms, or thighs [4, 5] with severe pruritus. And LA is reported to commonly present with MA lesions. Etiopathology and causal factors of LA have not been fully elucidated. And LA is considered to be related to heredity, long-term friction stimulation, EB virus infection, environment, and other factors [6]. The local itching may be the principal symptom of lichen amyloidosis, which appears 1-2 months before the papules and making the patients intolerable. The persistent and severe itching and recurrent multiple hyperkeratosis papules have a negative impact on patients’ quality of life [7]. Potent topical corticosteroids are generally used to treat lichen amyloidosis, which were considered failing or unsatisfactory in most patients [8, 9]. Other treatments, including antihistamine, calcipotriol, or phototherapy, can also relieve symptoms to a certain extent [10], but the efficacy still needs to be improved [11].
* Huaxu Liu [email protected] 1
Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
In our study, we try to use fractional laser to treat the refractory LA. The LA patients with unsatisfactory treatment outcome for previous long-term topical corticosteroids were collected to investigate the efficacy of fractional CO2 laser combined with topical corticosteroids in the treatment of intractable LA.
Materials and methods Patients This study has been approved by the Ethics Committee of Shandong Dermatology Hospital, and all patients have signed informed consent before treatment. Patients who had not responded well to previous topical corticosteroids for at least 1 month were included. All patients were not regarded with systemic drugs in the last 3 months, and pregnant and lactating women with coagulation disorders were excluded. The age of onset, course of the disease, site of the lesion, and type and degree of the lesion were recorded in detail. All patients were supported by pathological examination.
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