Currently, limited evidence exists supporting a definitive regimen in the management of lichen amyloidosis. Randomized controlled trials are needed to identify the appropriate treatment approach.4 The case presented suggests that a fixed combination of halobetasol-tazerotene therapy could be an effective off-label treatment in the management of lichen amyloidosis, as well as be an acceptable candidate for future trials. The synergistic effects of a topical corticosteroid and a topical retinoid reduce inflammation, and thus, decrease amyloid production. Furthermore, the addition of a retinoid reduces hyperkeratosis and epidermal acanthosis. Future well-controlled clinical studies would be needed to fully appreciate the potential.
2. Schreml S, Szeimies RM, Vogt T, Landthaler M, Schroeder J, Babilas P. Cutaneous amyloidoses and systemic amyloidoses with cutaneous involvement. Eur J Dermatol. 2010;20(2):152-160. doi:10.1684/ejd.2010.0842
3. Kang S. The mechanism of action of topical retinoids. Cutis. 2005;75(2 Suppl):10-13.
4. Weidner T, Illing T, Elsner P. Primary localized cutaneous amyloidosis: a systematic treatment review. Am J Clin Dermatol. 2017;18(5):629–642. https://doi.org/10.1007/s40257-017-0278-9