Treatment of lichenoid amyloidosis of the skin using CO2 ablative laser.

Cutaneous amyloidosis is a disorder resulting from a protein metabolism disorder, presenting by formation and extracellular deposition of a specific protein-polysaccharide complex, amyloid, in the skin. Lichenoid cutaneous amyloidosis is a form of primary localized cutaneous amyloidosis. This dermatosis is rare and affects both sexes equally. The impact of cutaneous amyloidosis on the psychological status and quality of life of patients is due to its chronic course, severe subjective discomfort, and the limited effectiveness of current treatment methods. Cutaneous amyloidosis is often accompanied by chronic pruritus, which is the dominant subjective symptom, causing significant anxiety, irritability, and sleep disturbances. It also leads to the development of secondary hyperpigmentation, which exacerbates aesthetic discomfort and increases psychological stress, especially in young women. The reasons for the low effectiveness of treatment are related to the nature of the disease and the mechanism of amyloid deposition in the skin. Localized forms of amyloidosis are easier to treat and correct than generalized forms. However, the use of quinoline drugs, unithiol, aromatic retinoids, topical glucocorticosteroids, topical calcineurin inhibitors, and other medications does not always produce desired results. A promising treatment for cutaneous amyloidosis is laser dermabrasion (ablative and non-ablative), aimed at mechanical removal or destruction of amyloid deposits in the skin. We present a clinical case of primary lichenoid cutaneous amyloidosis and the use of an adjunctive CO₂ ablative laser treatment, which demonstrated a significant positive effect in reducing lesions and pigmentation. Due to the growing interest in laser treatment methods for dermatoses of various origins, we consider it important to study and apply selective laser photothermolysis in the treatment of cutaneous amyloidosis, which may help develop a new approach to the treatment of skin diseases associated with metabolic disorders.