Secondary Cutaneous Amyloidosis Associated with Mycosis Fungoides
59th Medical Wing San Antonio United States
Pagination or Media Count:
Secondary localized cutaneous amyloidosis is often not clinically apparent, but may be seen histologically. It is associated with several skin tumors, and has been reported with PUVA use. To date, there are three reported cases of secondary localized cutaneous amyloidosis associated with mycosis fungoides prior to any treatment. We present a case of a 39-year-old female who presented to the dermatology clinic for evaluation of facial acne. During the exam, several 5-lOmm hypo pigmented patches were noted on the bilateral ventral forearms. Upon questioning, the patient reported a 16 year history of these asymptomatic lesions which had been diagnosed as vitiligo she denied prior treatments. No lymphadenopathy was noted. Under woods lamp, the lesions did not fluoresce. The differential diagnosis included morphea, hypopigmented mycosis fungoides, post-inflammatory hypomelanosis, or idiopathic guttate hypomelanosis. Histologically, an atypical intraepidermal lymphoid infiltrate was seen with scattered foci of globular amyloid deposition in the papillary dermis and in a perivenular distribution. Immunohistochemical stains revealed predominantly CD8 positive epidermotropic lymphocytes with partial loss of CD7. T-cell gene rearrangement studies were positive for clonality.
- Medicine and Medical Research