Year: 2018 I Volume: 2 I Issue: 1 I Page:
Dermoscopic Study Of Primary Cutaneous Amyloidosis –New Cartwheel And Horse-shoe Pattern Revealed
Rahul Kumar Sharma1
1Consultant Dermatologist, Ajmer
Dr. Rahul Kumar Sharma
Consultant dermatologist, Ajmer.
Cutaneous Amyloidosis is the anomalous deposition of amyloid in the skin. It is broadly classified into primary localized cutaneous amyloidosis( papular , macular and nodular amyloidosis) and secondary localized cutaneous amyloidosis. Some time it is difficult to differentiate it from other causes of pigmentation and similar non specific conditions. So we did an extensive one year dermoscopic study to reveal all possible dermoscopic signs of primary cutaneous amyloidosis(PCA ) in Indian cases. Aim – To study dermoscopic features of Primary cutaneous amyloidosis in Indian skin type patients. Study period – One year (from December 2016 to December 2017). Study subjects-All the patients who attended the dermatology clinic from December 2016 to December 2017 with the clinical diagnosis of PCA and who fulfilled the inclusion and exclusion criteria. Methodology- All the patients who attended the dermatology clinic from December 2016 to December 2017 with the diagnosis of PCA and who fulfilled the inclusion and exclusion criteria were recruited for the study. Dermoscopy was performed with DL4 dermatoscope. The images were further magnified with the help of smart phone. Results-. Our study showed various dermoscopic signs in cases of PCA. The commonest pattern was Central hub pattern (38.15 %) followed by non specific pigment configurations (17.1 %).Our study discovered two new dermoscopic signs(not mentioned in the earlier literature) which includes the Horseshoe pattern (6.57 %) and Cart-wheel pattern (7.89 %). The other classical patterns revealed in our dermoscopic study were amorphous pigment globules (14.47 %), central scar pattern (7.89 %) and patchy pigmentation with other patterns (7.89%). Discussion-Dermatoscopy is a novel helpful bedside noninvasive technique in clinical dermatology practice which allows us to make a quick and accurate diagnosis of PCA. It also helps to distinguish it from other mimickers of pigmentation. The common patterns were Central hub pattern (38.15 %) and non specific pigment configurations (17.1 %).Our study identified two novel dermoscopic signs which includes the Horseshoe pattern (6.57 %) and Cart-wheel pattern (7.89 %). The dermatoscopic diagnosis of PCA is made by the acquaintance and meticulous search of various signs and should not be dependent on the presence of single observation. Other recent dermoscopic study of PCA supported our findings . There are very few dermoscopic studies in PCA across the world. Therefore our study may be helpful in developing a strong scientific scaffold for further dermoscopic research to reveal its importance in the cases of PCA.
Key words: Primary Cutaneous Amyloidosis, Dermoscopy, Dermatoscope, Dermoscopy of Cutaneous Amyloidosis, PCA, Dermoscopy of Dark Skin