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A hyperpigmented, rippled eruption in a Hispanic woman. Macular amyloidosis.

REPORT OF A CASE A 26-year-old Hispanic woman was referred to the dermatology clinic for evaluation of a hyperpigmented eruption on her lower extremities of approximately 10 years' duration. The findings of a biopsy performed 3 years earlier were inconclusive. Triamcinolone cream provided some relief from pruritus. On physical examination, the patient was found to have striate and reticulate hyperpigmented plaques symmetrically distributed on the anterior aspect of her thighs and on the lower part of her legs ( Figure 1 ). The rippled morphological appearance of the plaques gave the eruption a distinctive corduroy appearance. Pinpoint dark-brown papules were seen within the plaques, and lichenification was noted ( Figure 2 ). A hematoxylin-eosin—stained biopsy specimen is shown in Figure 3 . What is your diagnosis? DIAGNOSIS: Macular amyloidosis. DISCUSSION Primary localized cutaneous amyloidosis comprises the nodular, papular ( lichen amyloidosis ), and macular types of amyloidosis. Macular amyloidosis is a