Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Net Letter
2020:86:2;230-230
doi: 10.4103/ijdvl.IJDVL_239_18
PMID: 31417070

Primary cutaneous amyloidosis of auricular concha

Xin Zhou, Quan Chen, Xin Tian
 Dermatology Department, Guangzhou Institute of Dermatology, Guangzhou, Guangdong, China

Correspondence Address:
Xin Zhou
Guangzhou Institute of Dermatology, Guangzhou, Guangdong
China
Published: 12-Aug-2019
How to cite this article:
Zhou X, Chen Q, Tian X. Primary cutaneous amyloidosis of auricular concha. Indian J Dermatol Venereol Leprol 2020;86:230
Copyright: (C)2020 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

Primary cutaneous amyloidosis of the auricular concha is a rare disease, characterized by yellow, flesh-colored, waxy or pearly papules and plaques in the auricular concha. We report a case of a 50-year-old female patient with primary cutaneous amyloidosis of the auricular concha and describe the dermatoscopic findings. This case represents the first dermatoscopic description of primary cutaneous amyloidosis of the auricular concha.

A 50-year-old female presented with a history of more than 1 year duration of asymptomatic, flesh-colored papules on both ears and a 3-year history of pruritic, light-brown macules on the upper back and extensor surfaces of the extremities. The patient was otherwise systemically well. Dermatological examination revealed multiple, flesh-colored, dome-shaped papules with a waxy surface, 1–3 mm in diameter, located on the auricular conchae bilaterally [Figure - 1]a. In addition, symmetrical dusky-brown macules were found on her upper back and extensor surfaces of the extremities [Figure - 1]b.

Figure 1:

There were no abnormal laboratory findings suggestive of systemic disease. The patient denied any significant medical, surgical, or family history.

On polarized light dermatoscopic [Figure - 2]; ×10; DermLite DL3N, 3Gen, Long Island, New York, USA] examination, multiple, white globular structures of variable sizes were seen on a background of a light brown and pink network. Some cysts aggregated into a cobblestone pattern.

Figure 2: Dermatoscopic findings revealed white globules on a background of a delicate network (×10)

A biopsy specimen was taken from one of the lesions on the ear; histological examination revealed hyperkeratosis, elongation of the rete ridges, pigment incontinence, and eosinophilic amorphous deposits in the widened dermal papillae [Figure - 3]. The material was positive for crystal violet and Congo red staining. Immunohistochemical staining of the deposits was CK34βE12-positive.

Figure 3:

Primary cutaneous amyloidosis of the auricular concha is a rare disease that was first described in 1988 by Hicks et al.[1] Clinically, it presents as small papular lesions on the external ear, including the auricular concha and external auditory canal with unilateral or bilateral involvement. The lesions may be yellow or flesh-colored or waxy or pearly papules and plaques. In contrast to classical lichen amyloidosus, it usually lacks pruritus. It is unrelated to systemic amyloidosis. The pathological findings include hyperkeratosis and homogeneous eosinophilic deposits within widened dermal papillae. These materials stained positively with crystal violet and Congo red, and they also reacted strongly on immunohistochemistry with CK34βE12 antibody, which suggests that the amyloid material has an epidermal origin. Patients with primary cutaneous amyloidosis of the auricular concha often have a good prognosis and can be treated by surgical resection.

Lichen amyloidosus and macular amyloidosis are two major forms of primary localized cutaneous amyloidosis. They are likely the result of focal epidermal damage, but the exact relationship between them is unknown. Coexistence of lichen and macular amyloidosis in the same patient is termed “biphasic amyloidosis.” There are currently only four case reports of the biphasic form of amyloidosis, whose lichenoid counterpart consists of papules on the external ear.[2],[3],[4] Involvement of the auricular concha in biphasic amyloidosis further supports the point that lichen amyloidosus and macular amyloidosis are clinical variants of the same process.

The dermatoscopic findings of this case showed multiple, white, globule-like structures of variable sizes on a background of a light-brown and pink network. Some cysts aggregated into a cobblestone pattern. We suggest that the globule-like structures and cobblestone pattern are due to amyloid deposits in the widened dermal papillae. This structure is consistent with the “central hub,” which was mentioned by Chuang et al.[5] Hyperpigmentation is less prominent in this form of primary cutaneous amyloidosis. This report is the first description of the dermatoscopic features of primary cutaneous amyloidosis of the auricular concha. More studies are essential to establish the definite dermatoscopic patterns.

The patient denied any surgical treatment and was given a follow-up examination.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understand that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Open subject of Key Laboratory of Dermatology Department of Education (201702042).

Science and Technology Program of Guangzhou, China (201804010058).

Conflicts of interest

There are no conflicts of interest.

References
1.
Hicks BC, Weber PJ, Hashimoto K, Ito K, Koreman DM. Primary cutaneous amyloidosis of the auricular concha. J Am Acad Dermatol 1988;18:19-25.
[Google Scholar]
2.
Bakos L, Weissbluth ML, Pires AK, Müller LF. Primary amyloidosis of the concha. J Am Acad Dermatol 1989;20:524-5.
[Google Scholar]
3.
Barnadas MA, Pérez M, Esquius J, Curell R, de Moragas JM. Papules in the auricular concha: Lichen amyloidosus in a case of biphasic amyloidosis. Dermatologica 1990;181:149-51.
[Google Scholar]
4.
Errol C. Lichen amyloidosis of the auricular concha: Report of two cases and review of the literature. Dermatol Online J 2006;12:1.
[Google Scholar]
5.
Chuang YY, Lee DD, Lin CS, Chang YJ, Tanaka M, Chang YT, et al. Characteristic dermoscopic features of primary cutaneous amyloidosis: A study of 35 cases. Br J Dermatol 2012;167:548-54.
[Google Scholar]

Fulltext Views
3,189

PDF downloads
3,528
Show Sections