{'fraction_non_alphanumeric': 0.033460803059273424, 'fraction_numerical': 0.01338432122370937, 'mean_word_length': 5.0491329479768785, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 1, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Tumid Amyloidosis: A Novel Type of Primary Localized Cutaneous Amyloidosis?

To the editor: Cutaneous amyloidosis may occur in a systemic form; it may be wholly localized to the skin. Localized cutaneous amyloidosis may be primary or secondary in type, the latter of which is the more common (1). Primary localized cutaneous amyloidosis (PLCA) is comprised of macular, lichen, and nodular (tumefactive) forms, and several rare types, which include anosacral cutaneous amyloidosis, bullous amyloidosis, and vitiliginous amyloidosis (1–4). The amyloid fibrils of nodular amyloidosis are of the immuloglobulin AL type and are believed to arise as a result of local aberrant light chain material production by clonally expanded plasma cells. Macular amyloidosis and lichen amyloidosis are two closely related forms of PLCA (5). The fibrils of these types of amyloidosis are believed to originate from epidermal keratinocytes. This belief is supported by the finding that dermal amyloid deposits in these forms of PLCA cross-react immunohistochemically with keratin (6). Macular amyloidosis is characterized by dark brownish macules arranged in a reticulated or rippled pattern with moderate pruritus. The lesion usually occurs in a symmetrical distribution over the upper back and arms. In lichen amyloidosis, closely set, discrete, firm, hyperkeratotic papules and plaques are seen on the shins or the outer sides of the forearms (5), and intense pruritus is invisibly present. Interestingly, macular and lichen amyloidosis may frequently coexist (7), and some macular amyloidosis lesions have small, deep, brown papules within the area of hyperpigmentation. Herein, we report a case of a 63-year-old man with a skin lesion on his back, which had a 30-year history. The lesion was composed of closely-set tiny papules on a brownish plaque; it had a verrucous surface and measured 2.5 × 3.0 cm (Fig. 1). The patient had not experienced any itching sensation or discomfort due to the lesion. He had not rubbed or scratched the lesion. The clinical The Journal of Dermatology Vol. 32: 509–510, 2005