Dermal Change Due to Deposition


Fig. 22.1 Macular amyloidosis. 


image

Fig. 22.2 Lichen amyloidosis. A, Courtesy, Sean Christensen, MD PhD.



Histopathology:


Light pink, smooth deposits in the papillary dermis, often with associated pigment incontinence; deposits are larger and associated with epidermal hyperplasia in lichen amyloidosis


Deposits stain with cytokeratins






Pretibial Myxedema (Fig. 22.3)


Pink plaque(s) that are nodular in later stages, especially on the lower extremity


image

Fig. 22.3 Pretibial myxedema. A shows an early lesion of indurated erythema with a biopsy site. A, Courtesy, Kalman Watsky, MD.





Histopathology:


Mucin throughout the reticular dermis



Adult Colloid Milium (Fig. 22.4)


Brown to yellow translucent papules, especially on chronically sun-damaged skin of the face and/or hands but other sites may be affected


image

Fig. 22.4 Colloid milium. A, From Lewis AT, Le EH, Quan LT, et al. Unilateral colloid milium of the arm. J Am Acad Dermatol. 2002;46:S5–7, © Elsevier.





Histopathology:


Nodules of pink, fissured material



Lipoid Proteinosis (Fig. 22.5)


Genodermatosis with mutations in ECM1


image

Fig. 22.5 Lipoid proteinosis. A, Courtesy, Julie V Schaffer, MD. A, From Bolognia JL, Jorizzo JL, Schaffer JV. Dermatology, 3e. London: Saunders, 2012, with permission.

Waxy papules and plaques on extensor surfaces and face with scarring






Histopathology:


Pink dermal material, sometimes with a vertical orientation in the upper dermis; material may be accentuated around adnexal structures



Erythropoietic Protoporphyria (Fig. 22.6)


Genodermatosis, mutation in ferrochelatase


image

Fig. 22.6 Erythropoietic protoporphyria. A, Courtesy, Yale Dermatology Residents’ Slide Collection. B, Courtesy, Gillian Murphy, MD. From Bolognia JL, Jorizzo JL, Schaffer JV. Dermatology, 3e. London: Saunders, 2012, with permission.

Sun-exposed skin is affected, especially the nose, cheeks, and dorsal hands


Erythema, erosions, waxy scarring






Histopathology:


Pink dermal material around vessels (early lesions) and/or filling the upper dermis (later lesions)


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Mar 5, 2017 | Posted by in Dermatology | Comments Off on Dermal Change Due to Deposition

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