Clinical pattern of primary cutaneous amyloidosis in Hong Kong Chinese

Objective: To evaluate and assess patients with primary cutaneous amyloidosis with regard to sex, age and clinico-pathologic features in the local population. Design: Retrospective case study. Setting: Social hygiene clinic in Tuen Mun, New Territories, Hong Kong. Patients: Chinese patients with a clinical +/histological diagnosis of primary cutaneous amyloidosis: lichen amyloidosis and macular amyloidosis. Results: A total of 11 Chinese patients with primary cutaneous amyloidosis were successfully recruited at the Tuen Mun Social Hygiene Clinic from July to December 2008. Mean age of patients was 55.8 years with a male to female sex ratio of 1.2 to 1. Most patients (63.6%) presented after 40 years old (43-67 years old). The average age of onset was 45.3 years old (16-67 years old). Pruritus was the most common complaint. Limbs and upper back were most frequently affected. About half of the patients (45.5%) reported a significant reduction of itch (≥50% reduction in severity) with topical steroid with/without salicylic acid or oral antihistamine. However, there was no improvement in pigmentation or skin texture. Conclusion: Clinicians should bear in mind the possibility of primary cutaneous amyloidosis when encountering middle age patients presenting with localized pruritic skin lesions on limbs or upper back. Simple treatments with topical steroid with/without salicylic acid can usually ameliorate pruritus though improvement in pigmentation and skin texture is not promising.