Answer to Image of the Month December 2013

Submitted by M Ramam, Manoj Singh

 

Lichen amyloidosus

There is a deposit of amorphous pink material with some clefts in the papillary dermis, accompanied by a few melanophages. The deposit focally abuts on the overlying epidermis. This amyloid is derived from keratinocytes and the condition has no relationship to systemic amyloidosis.

Congo Red stains the deposit pinkish-orange and also reveals similar material in the adjacent papillae.

 

congoredCongo Red staining of the papillary dermal deposits of amyloid

Lichen amyloidosus presents clinically as very itchy, small papules arranged in rows with intervening normal-looking skin producing a distinctive, recognizable pattern.

lichenamyloidosusclinicalLichen amyloidosus on the leg