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September 1972

Biphasic Amyloidosis: Link Between Macular and Lichenoid Forms

Author Affiliations

New York

Memphis, Tenn

New York

Arch Dermatol. 1972;106(3):419. doi:10.1001/archderm.1972.01620120093029

To the Editor.—  It has previously been suggested1 that lichenoid and macular amyloidosis may represent the same basic disease process; the important difference between these conditions is not the amount of amyloid deposited but the presence of epidermal hyperplasia in the former condition and its absence in the latter. During the past few months, we have had the unique opportunity to study two Puerto Rican women with lichen amyloidosus of one leg and macular amyloidosis of the other.The first patient manifested a pruritic lichenoid eruption of the right leg and barely discernible speckles of brown macular pigmentation on the left side. A biopsy specimen from the right limb disclosed epidermal hyperplasia and amyloid deposits in the papillary dermis, confirming the clinical impression of lichen amyloidosus. The lower portion of the left limb had been deformed, and sensation had been impaired since birth. Light and electron microscopic examination