LAUSR

The primary localized cutaneous amyloidosis (PLCA) is characterized by the extracellular deposition of amyloid proteins in previously normal skin without systematic involvement [1]. Themain subtypes of PLCA have been identified, which comprises lichen amyloidosis (LA), macular amyloidosis (MA), and nodular amyloidosis (NA). Additionally, the combined appearance of different subtypes will occur [2, 3]. Lichen amyloidosis (LA), the most common form of PLCA, presents with localized or rarely generalized, hyperpigmented macules or papules, which is usually located on the shins, calves, dorsal feet, forearms, or thighs [4, 5] with severe pruritus. And LA is reported to commonly present with MA lesions. Etiopathology and causal factors of LA have not been fully elucidated. And LA is considered to be related to heredity, long-term friction stimulation, EB virus infection, environment, and other factors [6]. The local itching may be the principal symptom of lichen amyloidosis, which appears 1-2 months before the papules and making the patients intolerable. The persistent and severe itching and recurrent multiple hyperkeratosis papules have a negative impact on patients’ quality of life [7]. Potent topical corticosteroids are generally used to treat lichen amyloidosis, which were considered failing or unsatisfactory inmost patients [8, 9]. Other treatments, including antihistamine, calcipotriol, or phototherapy, can also relieve symptoms to a certain extent [10], but the efficacy still needs to be improved [11]. In our study, we try to use fractional laser to treat the refractory LA. The LA patients with unsatisfactory treatment outcome for previous long-term topical corticosteroids were collected to investigate the efficacy of fractional CO2 laser combined with topical corticosteroids in the treatment of intractable LA.