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May 1987

Nylon Brush Macular Amyloidosis

Author Affiliations

From the Department of Dermatology and Sy(Drsology, Wayne State University School of Medicine, Detroit (Drs Hashimoto, Kumakiri, and Ito); the Veterans Administration Medical Center, Allen Park, Mich (Drs Hashimoto, Kumakiri, and Ito); and the Department of Dermatology, University of Michigan, Ann Arbor (Dr Headington).

Arch Dermatol. 1987;123(5):633-637. doi:10.1001/archderm.1987.01660290101025

• Long-term use of a nylon brush for back scratching by a 53-year-old white woman was associated with the development of typical macular amyloidosis. EKH4 monoclonal antikeratin antibody, which recognizes 50-kd neutral and acidic keratin species, labeled this amyloid. Confirmation of amyloid substance in the lesion included positive staining with Dylon and thioflavin T; immunohistochemical reactions with monoclonal and polyclonal antibodies against elastic fiber microfibrils (NKH1 and anti-P component), immunoglobulins (IgG, IgM, and IgA), and complement (C3); and electron microscopic identification of 6- to 10-nm straight filaments. Type IV collagen staining demonstrated a breakage and/or thickening of the dermoepidermal basement membrane above the amyloid deposition in the papillary dermis. Electron microscopic findings confirmed this phenomenon.

(Arch Dermatol 1987;123:633-637)

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