Localized Cutaneous Amyloidosis in Diabetics

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  • 糖尿病者にみられる限局性皮膚アミロイド症
  • トウニョウビョウシャ ニ ミラレル ゲンキョクセイ ヒフ アミロイドショウ

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Macular amyloidosis, a type of localized cutaneous amyloidosis, was observed at a relatively high frequency among diabetics. The skin lesions were generally located on the shoulders and extensors of the forearm. The characteristic manifestation was brown or darkbrown spotty pigmentation which corresponded to the dermal papillae. Itching was rare or only slight.<BR>Histological examination revealed foci of amyloid material situated in the dermal papillae. The amyloid deposits were not distinguishable with haematoxylin-eosin stain, but favorable results were obtained with Van Gieson stain (light yellow), crystal violet stain, and methyl violet stain (light reddish violet). In particutar, by using the technique of thioflavine-T staining, the amyloid substance was easily recognized from its characteristic yellow fluorescence.<BR>Neither the pathogenesis of localized cutaneous amyloidosis nor the significance of relatively high amounts of amyloid substance in diabetics has yet been explained.<BR>Diabetic patients usually display various forms of dermatopathy, and such chronic inflammation and irritation of the skin may possibly lead to deposition of amyloid substance in the skin.<BR>On the other hand, there are many reports of considerable amyloid deposition in the islets of Langerhans in diabetic patients, so the possibility exists that metabolic disturbance in the diabetic state may have a close relation to amyloid deposition in the skin. Further investigations are required.

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