Analysis Of Clinical Presentation, Treatment And Skin Tissue Pathology In 30 Cases With Primary Cutaneous Amyloidosis

Objective The study was aimed to investigate the relationship between clinical features, curative effects and histopathology of skin lesions of primary cutaneous amyloidosis(PCA), and detect the expressions of CK5, CD 16, and CD206 cytokines in skin lesions to make some understanding of the pathogenesis of PCA.Methods The clinical data of 30 PCA patients were collected. And observation schedule was designed to follow and record the curative effects. The links between histopathology of skin lesions, clinical features and curative effects of 30 PCA cases were analyzed. Expressions of CK5, CD 16, and CD206 cytokines were inspected via immunohistochemical technology. Data obtained were analyzed with SPSS 16.0 statistical software.Result Totally 30 PCA patients were included in the study,17 females and 13 males. There was 20 cases of Lichen Amyloidosus Among them, accounted for 66.7%,4 cases of Macular Amyloidosis, accounted for 13.3%,5 cases of Biphasic Amyloidosis, accounted for 16.7%, and 1 case of Poikilodermalike cutaneous amyloidosis, accounted for 3.3%.22 cases appeared itching, and 8 cases did not. Different degrees of the scattered keratinocytes or necrotic keratinocytes were seen in all included cases in microscope. The mean of the inflammatory cells(histocytes and lymphocytes) in one dermal papilla of skin lesions of patients with itch was 30.19±20.88, and it was 14.74±2.73 in patients without itch, the difference was statistically significant (P<0.05). Scores before and after treatment of patients with serious inflammatory cell infiltration(>20 inflammatory cells per dermal papilla) and with mild inflammatory cell infiltration(<20 inflammatory cells per dermal papilla) had no difference(P> 0.05). CK5 cytokines expressed focally in skin tissue with lesions of 8 patients. Expressions of CD 16 and CD206 cytokines were not detected in histocytes of skin tissue with lesions of 30 patients.Conclusion (1) The degree of inflammatory cell infiltration in skin lesion of PC A patients was correlated with itching, but unrelated to curative effects. (2) The development of PCA amyloid-like substance may had relation with apoptosis and necrosis of keratinocyte.