(BMJ)—A man in his 60s with well-managed HIV presented with a 20-year hx of multiple hyperpigmented itchy lesions. Exam: papulonodular and coalesced plaques on legs, arms, and buttocks. Bx confirmed the dx. What is it?
Prurigo nodularis
Notalgia paresthetica
Lichen amyloidosis
Lymphomatoid papulosis
Lichen simplex chronicus
You are correct. Thioflavin T and Congo red staining of bx sample were consistent with lichen amyloidosis, characterized by cutaneous deposition of amyloid proteins, without systemic involvement. His HIV wasn’t considered to be a predisposing factor. The focus of management for lichen amyloidosis is on sx control; evidence for tx is limited.

This patient received topical steroids and phototherapy. The pruritus improved without any change to the clinical appearance.

BMJ 2021;372:n315