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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty-five patients with presumptive macular amyloidosis were investigated for the presence of amyloid in dermal tissue. In twenty-six of these patients the diagnosis could be confirmed by the demonstration of amyloid deposits by optical and/or electron microscopy. In this paper attention is called to the frequency of oligosymptomatic forms of macular amyloidosis, which are often overlooked in spite of the usual existence of itching. These inconspicuous forms are termed "minor macular amyloidosis", and they consist of tenuous brown macules on the upper back, irregularly interspersed with the normal skin and with speckles of whitish discoloration. The diagnosis must be verified by the finding of dermal deposits of amyloid. For that purpose the electron microscopy is a much more reliable procedure than conventional methods or thioflavine T.
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PMID:[Macular amyloidosis]. 36 58

Three patients of a French family demonstrated an association of multiple endocrine neoplasia type 2A (MEN 2A) with a pruritic scapular skin lesion. The lesions are similar to those described as familial cutaneous lichen amyloidosis in unrelated MEN 2A and medullary thyroid carcinoma families, but histological, immunohistochemical, and ultrastructural analysis of skin biopsies from each patient in the French family did not show amyloid deposition. The topography of the lesion follows dermatomes C8-D3. The patients report not only pruritus but also paresthesia and hyperalgesia, and one showed touch hypoesthesia and pain hyperesthesia in the area of the lesion. Such an association of cutaneous and neurological features suggests notalgia paresthetica (NP), a neuropathy of the posterior dorsal rami nerves. We thus suggest that the cutaneous lesions associated with MEN 2A might be secondary to pathology in the neural crest-derived dorsal sensory nerves. The amyloid, when present, would be secondary to scratching. We propose that patients presenting with familial NP be suspect for MEN 2A.
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PMID:Cutaneous lesion associated with multiple endocrine neoplasia type 2A: lichen amyloidosis or notalgia paresthetica? 136 14

A 40-year-old woman who had used nylon towels in the bath for about 10 years noticed hyperpigmentation on the prominent regions over the bones of the trunk and extremities. She also developed lichenoid papules with itching on her back. Histologically, both the pigmented and the papular lesions had amyloid deposits beneath the epidermis. In this case it is presumed that the papular lesions with amyloid (lichen amyloidosus) developed initially from friction melanosis which became macular pigmented lesion (macular amyloidosis). The etiologic factor of these sequential pathologic changes is considered to be repeated scrubbing with nylon towels.
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PMID:Biphasic amyloidosis arising from friction melanosis. 207 47

Amyloidosis maculosa is a clinical entity with low incidence factor in our medium, which basically affects middle-aged women. The lesion is characterised by the presence of poorly defined, hyperpigmented, brownish or greyish maculae that converge and focus basically on the upper back and shoulders, usually accompanied by pruritus. Three patients were erroneously catalogued for years as having pityriasis versicolor. Two of these patients presented a typical clinical amyloidosis maculosa, and the third presented a less common manifestation of the disease: a single, well-defined lesion in the subscapular region. We believe that the approach to the diagnosis of pityriasis versicolor with hyperpigmented lesions that do not respond to specific treatment should be revised. Although amyloidosis maculosa has a low incidence in our medium, it is an entity which should not be discarded in these cases.
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PMID:[Amyloidosis maculosa: diagnosis in primary care]. 212 37

Cutaneous lesions are present in up to 40% of patients with primary and myeloma-associated systemic amyloidosis and occur as a result of tissue deposition of immunoglobulin light chain material derived from a circulating paraprotein. The occurrence of waxy, purpuric mucocutaneous lesions provides a crucial early pointer to underlying occult plasma cell dyscrasia; the combination of the symptoms of the carpal tunnel syndrome, macroglossia, and specific mucocutaneous lesions is highly characteristic. Although secondary systemic (reactive) amyloidosis rarely gives rise to clinically evident cutaneous lesions, it may be etiologically related to a number of chronic dermatoses. Lesions of nodular primary localized cutaneous amyloidosis are indistinguishable from those of primary and myeloma-associated systemic amyloidosis, and they result from local plasma cell infiltration. Macular and papular (lichen amyloidosus) variants of primary localized cutaneous amyloidosis may have a familial or racial basis and are characterized by a tendency for keratinocytes to undergo filamentous degeneration and apoptosis. The prognosis of patients with plasma cell dyscrasia-related systemic amyloidosis remains poor, since there is little response to therapy with cytotoxic agents, colchicine, or dimethylsulfoxide. Colchicine is the drug of choice in the prevention and treatment of the renal amyloidosis associated with familial Mediterranean fever, and dimethylsulfoxide may be useful in the management of patients with secondary systemic amyloidosis. Macular amyloid and lichen amyloidosus generally follow a chronic course with intractable pruritus; there have been isolated reports of the beneficial effect of dermabrasion, topical dimethylsulfoxide, and therapy with the aromatic retinoid, etretinate.
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PMID:Amyloid and amyloidosis. 327 77

This study is based on clinical findings in 160 patients with skin-limited amyloidosis: 151 macular, 8 biphasic and 1 lichen amyloidosis. 82.5 p. 100 of the patients were women and 17.5 p. 100 were men. 95 p. 100 of the patches were located in the back and 64 p. 100 in the suprascapular region. No less than 88 p. 100 of the patients had pruritus on the patches or on other sites. 75 p. 100 had allergic diseases or a history of allergy, and 45 p. 100 had non-allergic pruriginous diseases. Signs of scratching were noted in most of the patients. The principal causes of pruritus were dermographism, photodermatitis and dermatitis. Macular amyloidosis is now considered as secondary to scratching motivated by pruriginous diseases and not as a primary condition as hitherto described. The term "scratch amyloidosis" is proposed for macular and lichenoid amyloidosis, and the existence of a "preamyloidotic" histological stage is described.
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PMID:[Origin of macular amyloidosis. Apropos of 160 cases]. 367 63

Macular amyloidosis, a variant of lichen amyloidosus, is an uncommon cutaneous eruption that presents with moderate to severe pruritus associated with areas of hyperpigmentation. Effective modalities for the treatment of this condition have been lacking. A case of macular amyloidosis is reported in which successful management of pruritus was obtained using ultraviolet B (UVB) therapy. Mechanisms of UVB action in this condition are discussed.
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PMID:Macular amyloidosis: treatment with ultraviolet B. 373 72

A case of primary localized cutaneous amyloidosis followed up during 35 years is reported. The initial lesions and the pruritus disappeared after years of evolution and new lesions appeared in other areas. These findings confirm previous observations of the author who reported on 24 patients with primary localized cutaneous amyloidosis followed up for 20 to 30 years. In seven of them amyloid was demonstrated in areas where clinical lesions had disappeared. In most patients either the clinical lesions the pruritus, or both had disappeared and in many patients other clinical lesions had appeared in other locations.
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PMID:[Genuine cutaneous amyloidosis. Natural course]. 388 56

DMSO is a clear odorless liquid, inexpensively produced as a by-product of the paper industry. It is widely available in the USA as a solvent but its medical use is currently restricted by the FDA to the palliative treatment of interstitial cystitis and to certain experimental applications. Cutaneous manifestations of scleroderma appear to resolve (albeit equivocally) following topical applications of high concentrations of DMSO. A limited number of small clinical trials indicate that intravenous DMSO may be of benefit in the treatment of amyloidosis, possibly by mobilizing amyloid deposits out of tissues into urine. Dermal application of DMSO seems to provide rapid, temporary, relief of pain in patients with arthritis and connective tissue injuries. However, claims for antiinflammatory effects or acceleration of healing are currently unwarranted. There is no evidence that DMSO can alter progression of degenerative joint disease, and, for this reason, DMSO may be considered for palliative treatment only and not to the exclusion of standard antiinflammatory agents. The safety of DMSO in combination with other drugs has not been established; neurotoxic interactions with sulindac have been reported. In experimental animals, intravenous DMSO is as effective as mannitol and dexamethasone in reversing cerebral edema and intracranial hypertension. An initial clinical trial in 11 patients tends to support this latter application. DMSO enhances diffusion of other chemicals through the skin, and, for this reason, mixtures of idoxuridine and DMSO are used for topical treatment of herpes zoster in the UK. Adverse reactions to DMSO are common, but are usually minor and related to the concentration of DMSO in the medication solution. Consequently, the most frequent side effects, such as skin rash and pruritus after dermal application, intravascular hemolysis after intravenous infusion and gastrointestinal discomfort after oral administration, can be avoided in large part by employing more dilute solutions. Most clinical trials of DMSO have not incorporated the components of experimental design necessary for objective, statistical evaluation of efficacy. Randomized comparisons between DMSO, placebo and known active treatments were rarely completed. Final approval of topical DMSO for treatment of rheumatic diseases in particular will require a multi-center, randomized comparison between high and low concentrations of DMSO and an orally-active, nonsteroidal antiinflammatory agent.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Medical use of dimethyl sulfoxide (DMSO). 391 2

We describe 23 cases of unusual brownish pigmentation occurring over the bony tissues such as clavicle, scapula or vertebrae. There were 19 females and 4 males. The age ranged from 18 to 59, mostly between 20 and 35 years. Since the first observation in 1977, cases gradually increased. The pigmentation usually showed ripple pattern on the upper back and clavicular region, zebra-like pattern over the ribs and postage-stamp-like macule over the vertebral column. Although there was no inflammatory sign such as itching or scaling, histology revealed postinflammatory melanin deposit in the upper dermis. Exceptional detection of amyloid deposit in the papillary layer in one case could be secondary to the slight epidermal damage actually disappeared. The general condition was not affected, and laboratory data remained within normal limits. This unique melanosis should be separated from other pigmentary disorders and macular amyloidosis. We would like to propose the name of friction melanosis, because this condition should be intimately related with the repeated friction by nylon towel or brush, widely used by young peoples in the bathroom.
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PMID:[Friction melanosis]. 652 77


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