Macular amyloidosis: a case report

Area of Science:

• Dermatology
• Histopathology
• Clinical Medicine

Background:

• Macular amyloidosis is a rare cutaneous condition causing skin pigmentation, more prevalent in Asia and South America than in Western countries.
• Its exact cause is unclear, but chronic friction is a significant suspected risk factor.
• This case study focuses on a patient diagnosed with macular amyloidosis in Croatia.

Observation:

• A 54-year-old patient presented with persistent grayish-brown pigmentation on the scapula, localized itching, and a compulsive scratching urge.
• Diagnostic confirmation involved patient history and histological examination revealing amyloid deposits.
• The patient underwent a three-month treatment with tretinoin.

Findings:

• Tretinoin therapy led to significant alleviation of pruritus (itching).
• However, the hyperpigmentation on the scapula showed no improvement after the three-month treatment period.
• This suggests that while tretinoin may manage symptoms like itching, it does not resolve the visible skin changes.

Implications:

• The case highlights the diagnostic criteria for macular amyloidosis, including clinical presentation and histological evidence.
• It underscores the limited effectiveness of current therapies like tretinoin in reversing the characteristic hyperpigmentation.
• Further research is needed to clarify the pathogenesis and explore more effective treatment strategies for macular amyloidosis, as its prevalence may be underestimated in regions like Croatia.