To the Editor.—
Brownstein and Helwig1 do not agree with those who think that the classification of amyloidosis is dated. Those with a contrary opinion would point to the sameness of amyloid material on ultramicroscopic investigation regardless of its site and its clinical classification. In addition such datum as the finding of renal amyloidosis as frequently in what has been labeled primary amyloidosis as it is in what has been labeled secondary amyloidosis2 supports this viewpoint.With this in mind we think that statements to the effect that "systemic amyloidosis" does not occur in patients with lichen amyloidosus should be modified. Cardiac amyloidosis has been found in a high percentage of elderly people who do not have the disease called amyloidosis. One would expect that some elderly people who have or have had lichen amyloidosus will show cardiac amyloid if the pertinent staining techniques are done at autopsy.
Cohen HJ, Minkin W. CLASSIFICATION OF AMYLOIDOSIS. Arch Dermatol. 1971;103(5):566-567. doi:10.1001/archderm.1971.04000170100030