Macular Amyloidosis

What is Macular Amyloidosis?

Macular amyloidosis is a pruritic eruption that is variable in severity and consists of small, dusky-brown or greyish pigmented macules distributed symmetrically over the upper back and, in some patients, the arms.

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Who are affected?

  • It mainly affects the adult population. Women are more prone compared to men.
  • It is most common in Asians, Middle Eastern and South Americans.

What are the signs and symptoms?

It is a pruritis condition, usually small dusky brownish pigmented eruptions are distributed on upper back and occasionally spreads to arm.

Can I be cured completely?

No, but don’t worry as it can be helped to keep it under control (remission) which will allow you to live a better life.

What happens inside my body when I have macular amyloidosis?

The amyloid deposits in macular amyloidosis are keratinocyte-derived. The exact pathogenesis leading to the apoptosis of keratinocytes is not clear but trauma such as friction (rubbing and scratching), genetic predisposition, infectious agents, and ultraviolet radiation are possible causes.

What are the various treatments available and which one will help me ?

There are various treatments such as –

  • Topical corticosteroids
  • Topical calcineurin inhibitors
  • Intralesional corticosteroids
  • Systemic retinoids
  • Systemic cyclophosphamide

Physical modalities

  • Ultraviolet (UV) B phototherapy (narrow band and broadband)
  • PUVA (psoralen with UVA) phototherapy

Surgical options

  • Dermabrasion
  • CO2 laser therapy

Homeopathy is the best option which is safe and can be taken for long duration without affecting your vital organs as body develops resistance when corticosteroids are taken for longer duration and there are several side-effects which hamper vital organs of the body.

-Systemic retinoids cause dryness of skin which may lead to hyperpigmentation and photosensitivity.

-UVA and UVB radiations expose to risk in Melanoma which is even more threatening.

-Treatments like CO2 Laser which is an Ablative laser and Dermabrasion are again unsafe procedure as it causes post inflammatory hyperpigmentation and occasionally laser burns.

Can Homeopathy help in this condition?

Yes, Homeopathy can help in controlling this condition and it may improve gradually up-to an extent.

What are the complications?

Macular amyloidosis has not been reported to progress to systemic disease with the amyloid deposits exclusively localized to the skin. However, there is evidence linking primary localized cutaneous amyloidosis to a variety of immune disorders including systemic sclerosis, CREST syndrome, rheumatoid arthritis, systemic lupus erythematosus, primary biliary cirrhosis, autoimmune cholangitis, Kimura disease, ankylosing spondylitis, autoimmune thyroiditis, IgA nephropathy, and sarcoidosis.

In some families with the hereditary forms of primary localized cutaneous amyloidosis, an association with multiple endocrine neoplasia (MEN) type 2A, also known as Sipple syndrome, has been established. MEN type 2A is an autosomal dominant disorder including the triad of medullary carcinoma of the thyroid, pheochromocytoma, and hyperparathyroidism.

What if I do not take any medicines?

The itching becomes unbearable and it deteriorates quality of day today life, constant itching leads to further friction which aggravates the condition, so it is a vicious cycle which gets in control with the help of medication.

What investigation are needed to confirm the diagnosis?

Skin Biopsy can be conclusive.

Congo red stains can demonstrate skin amyloid deposits.

What is the differential diagnosis?

-Pediatric Atopic Dermatitis

-Poikiloderma of Civatte

-Postinflammatory Hyperpigmentation

Can I live a normal life with such a condition?

Yes, Once the itching comes in control the quality of life improves. The hyperpigmentation can be helped by cosmetic concealers to help patient’s gain self-confidence.

What are the dietary restrictions in this condition?

-Omega-3 fatty acids (Prescribed dosage is recommended to avoid side effects)

-Vitamin C

How does this condition spread?

It is not contagious, it does not spread by touching the patient. It may pass on genetically from parent to child.

Which are commonly indicated Homoeopathic medication?

In such conditions constitutional medicine works the best, however few commonly indicated medicines are: –

-Hepar Sulp

-Sulphur

-Graphites

-Mezereum

-Psorinum

-Phytolacca Decandra

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