Acitretin for lichen amyloidosus

Abstract

We present two cases of lichen amyloidosus treated with retinoids. A 57-year-old Vietnamese woman has had extensive generalized recalcitrant lichen amyloidosus for 23 years. Treatment with oral etretinate (25 mg/day) for 3 years, and later oral acitretin (10 mg/day) for the past 10 years, has controlled the pruritus and flattened the hyperkeratotic papules. Whenever the acitretin was ceased her symptoms flared within weeks. On each occasion reintroduction of acitretin was effective within 1-2 months. The second case is that of a 51-year-old Australian Aboriginal woman who had a 2-year history of lichen amyloidosus affecting her lower legs. A 2-month course of oral acitretin (25 mg b.d.) produced a marked improvement in both the pruritus and hyperkeratotic papules. She was then lost to follow up for 2 years, during which time her symptoms recurred.

Primary localized cutaneous amyloidosis with lichen and poikiloderma-like lesions and an excellent response to systemic acitretin

“…Third, retinoids can also reduce apolipoprotein E secretion, a protein found together with amyloids that is considered crucial in promoting its formation. 7 As Gal-7 is an important amyloid precursor protein in PLCA, further studies are necessary to investigate the association between Gal-7 and retinoids.…”

Alitretinoin treatment of lichen amyloidosis

“…have therapeutic effects on LA in case reports (Atacan, Ergin, Çelik, G€ on€ ul, & Adaba g, 2016;Carlesimo et al, 2011;Choi, Sippe, & Lee, 2008). Although the exact mechanism of effectiveness has not been revealed, several hypotheses have been proposed (Atacan et al, 2016;Carlesimo et al, 2011;Choi et al, 2008).…”

“…Although the exact mechanism of effectiveness has not been revealed, several hypotheses have been proposed (Atacan et al, 2016;Carlesimo et al, 2011;Choi et al, 2008). The immunomodulatory effects of retinoids may inhibit inflammatory injuries to basal keratinocytes that are thought to be the source of keratin-derived amyloid (Atacan et al, 2016;Carlesimo et al, 2011;Choi et al, 2008). Retinoids may suppress epidermal proliferation and promote keratinocyte differentiation, leading to the improvement of acanthosis and hyperkeratosis (Atacan et al, 2016;Carlesimo et al, 2011;Choi et al, 2008).…”

“…The immunomodulatory effects of retinoids may inhibit inflammatory injuries to basal keratinocytes that are thought to be the source of keratin-derived amyloid (Atacan et al, 2016;Carlesimo et al, 2011;Choi et al, 2008). Retinoids may suppress epidermal proliferation and promote keratinocyte differentiation, leading to the improvement of acanthosis and hyperkeratosis (Atacan et al, 2016;Carlesimo et al, 2011;Choi et al, 2008). In addition, retinoids can regulate levels of several heat-shock proteins and apolipoprotein E, which are thought to be important factors in the formation of amyloid from keratin (Hansen et al, 2001).…”

Successful treatment of lichen amyloidosus with oral alitretinoin

“…Several reports describe good responses to treatment with retinoids such as acitretin and etretinate . Most retinoids, however, lead to dryness of the skin, which may eventually deteriorate the itch.…”