Primary Localized Cutaneous Amyloidosis: A Systematic Treatment Review

Weidner, Till; Illing, Tanja; Elsner, Peter

doi:10.1007/s40257-017-0278-9

Cited by 83 publications

(110 citation statements)

References 87 publications

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“…Authors had listed several side effects for topical DMSO including contact urticaria, desquamation, burning sensation, and garlic‐like breath odor mostly in the high concentration use . In the present study, no adverse reaction was observed on both sides.…”

Section: Discussionsupporting

confidence: 47%

“…Topical DMSO 10% to 100% solution is traditionally used to treat macular amyloidosis and lichen amyloidosis. Most of the publications showed promising outcomes within relatively short treatment period, and all of them reported an early reduction in pruritus, without regression of amyloid deposits . Only four studies with acceptable case numbers could be found in the literature .…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of topical dimethyl sulfoxide (DMSO) 50% solution vs tretinoin 0.5% cream in treatment of patients with primary macular amyloidosis: A split‐side single‐blinded randomized clinical trial

Saki

Ahramiyanpour

Heiran

et al. 2020

Dermatologic Therapy

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Primary localized cutaneous amyloidosis (PLCA) is a recalcitrant sporadic dermatological condition and most treatments have failed so far. We studied the efficacy of topical dimethyl sulfoxide (DMSO) 50% solution in comparison with tretinoin 0.5% cream in treatment of macular amyloidosis. In this split‐side within‐person single‐blinded randomized clinical trial, 18 patients with bilateral macular amyloidosis received topical DMSO 50% solution and tretinoin 0.5% cream either on their right or the left side. The colorimetry, pruritus scoring, and photography were done. A significant pigmentation decline per each follow‐up was observed in DMSO group compared to the tretinoin group (tretinoin: −1.31 vs DMSO: −7.34; difference in slopes: −6.03 [95% confidence interval: −12.06 to −0.01], PInteraction = .049). An insignificant diminution trend in pigmentation was observed for both treatments (Ptretinoin = .672, PDMSO = .092). Also, both treatments relived itchiness, but DMSO completely dispatched itchiness from the first follow‐up (P = .003 for tretinoin and <.0001 for DMSO). In conclusion, our results showed DMSO and tretinoin cream have the positive effect on the both pigmentation and itchiness in PLCA. DMSO may be more beneficial than tretinoin, since DMSO was significantly better in reducing itchiness. More investigations are warranted to provide sufficient evidence.

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Efficacy of topical dimethyl sulfoxide (DMSO) 50% solution vs tretinoin 0.5% cream in treatment of patients with primary macular amyloidosis: A split‐side single‐blinded randomized clinical trial

Saki

Ahramiyanpour

Heiran

et al. 2020

Dermatologic Therapy

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show abstract

“…Localized amyloidosis occurs in a variety of organ systems, including the skin and nails [35], larynx [36], lung [37] bowel [38], orbit [39], or urinary tract [40], including the renal pelvis, ureter, bladder, and urethra. Evolution of localized amyloidosis to systemic amyloidosis is rare [37].…”

Section: Localized Versus Systemic Amyloidosismentioning

confidence: 99%

Recent Advances in the Diagnosis, Risk Stratification, and Management of Systemic Light-Chain Amyloidosis

Vaxman

Gertz

2019

Acta Haematol

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The term amyloidosis refers to a group of disorders in which protein fibrils accumulate in certain organs, disrupt their tissue architecture, and impair the function of the effected organ. The clinical manifestations and prognosis vary widely depending on the specific type of the affected protein. Immunoglobulin light-chain (AL) amyloidosis is the most common form of systemic amyloidosis, characterized by deposition of a misfolded monoclonal light-chain that is secreted from a plasma cell clone. Demonstrating amyloid deposits in a tissue biopsy stained with Congo red is mandatory for the diagnosis. Novel agents (proteasome inhibitors, immunomodulatory drugs, monoclonal antibodies, venetoclax) and autologous stem cell transplantation, used for eliminating the underlying plasma cell clone, have improved the outcome for low- and intermediate-risk patients, but the prognosis for high-risk patients is still grave. Randomized studies evaluating antibodies that target the amyloid deposits (PRONTO, VITAL) were recently stopped due to futility and currently there is an intensive search for novel treatment approaches to AL amyloidosis. Early diagnosis is of paramount importance for effective treatment and prognosis, due to the progressive nature of this disease.

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“…Unfortunately, standardised treatment guidelines have not been established because of a lack of randomised control trials. 11 complaints of intense pruritus and the clinical appearance of the eruption. Long-term periodic follow-up is required as recurrence is common.…”

Section: Answermentioning

confidence: 99%

Persistently itchy papules

Aung

Rodins²

2019

Aust J Gen Pract

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Primary Localized Cutaneous Amyloidosis: A Systematic Treatment Review

Abstract: No definitive recommendation of preferable treatment procedures can be made based on the analyzed literature. Randomized controlled trials are needed to offer patients an evidence-based therapy with high-quality standardized treatment regimens for PLCA.

Cited by 83 publications

References 87 publications

Efficacy of topical dimethyl sulfoxide (DMSO) 50% solution vs tretinoin 0.5% cream in treatment of patients with primary macular amyloidosis: A split‐side single‐blinded randomized clinical trial

Efficacy of topical dimethyl sulfoxide (DMSO) 50% solution vs tretinoin 0.5% cream in treatment of patients with primary macular amyloidosis: A split‐side single‐blinded randomized clinical trial

Recent Advances in the Diagnosis, Risk Stratification, and Management of Systemic Light-Chain Amyloidosis

Persistently itchy papules

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