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Lichen Amyloidosis

โดย: Somnuk Amornsiripanitch, M.D.
Icthing bumps on lower legs that present as plaques on both legs as shownin in this photo is named Lichen Amyloidosis. Not much you can find information regarding this skin disease, forget it then to find the solution written in medical journals.
 
Many patients having this skin problem are south east asian people such as Thai , Singaporian, Loatian etc. When they try to seek medial help, most of the doctors do not have the answer for them.
 
By accident, I was asked by a patient to find the way to solve it. I always fond of finding the new challenge to solve but not much in sending the result for publications. New electronic social medias are more important and can be openly viewed by the public. Peer reviews of medical journals can not be compared with this new channel of communication, the fact coming out from patients are more valid and trustworthy.
 
Amyloidosis actually is a kind of protein that accumulates in dermal papilla and irritates the nerves that suppose to sense the skin. The aggravated itching of the already dry skin that generally co exist in this group of patient induces more itching and scratching after one has develpoed Lichen Amyloidosis which later results into more production of Amyloid protein. All the patients accept that they scrubbed their skin themselves or in the spa by professional personels for thinking that by doing so it was good for their skin. These habits are absolutely relating to the initiation and providing more pathological context for the occurence and progression of Lichen Amyloidosis. For you out there who are  having this problem, knowing this information and stop the bad habit will slow down the severity of Lichen Amyloidosis. For one who has not developed the problem yet, be careful with your habit of scrubbing your skin since it certainly will one day put you in misery.
 
Eating hot and spicy food, increasing your body temperature by any means also aggravate the icthing and end up making this problem worse. 
I consider this entity to be an inflammatory skin disease; therefore, avoiding sea food, beaf, fermented food and alcohol will help lessen the icthing and the inflammatory process.
 
Regarding to the treament, all of the old folk creams are proved to be worthless recommendations. Understanding  that all the proteins are built by amino acids bonding. This specific bond is formed by hydroxy bond between NH2 and COOH repeatedly across the entire length of proteins and it is well known that it will absorb infrared light. The idea of using long pulsed infrared light in Lichen Amyloidosis came to my mind when my first patient asked me for help. It did work and since then there are many cases were helped with the usage of this long pulse infrared laser. It needs more than a dozen sessions weekly to get the amyloid protein in to small fragmented particles that will be enzymatically digested in the natural process. The laser also lessens the icthying. However, there is legitimated concern that heat generated by laser may aggravate more inflammation; therefore, the antiinflammation pills must be prescribed systemically as well. The careful protocol of the dosage, the interval between each session the cooling system to prevent the laser burn are intergrated in the protocols for each patient for the best result.
 
 
Certainly, there were reported that Q switch laser and Fractional laser can be helpful. But base on my expereince the fractional laser can not destroy the amyloid protein as effectively as long pulse infrared laser and it does cause more inflammation. Q switch laser is good for the pigmentation of Lichen Amyloidosis but can not help much at all with the amyloid underneath those hyperpigmented top layer of your skin. 
 
Comprehensively, my recommendations are :
 
     1. Knowing how to rebehave on your skin is helping both in the treatment and in the prevention phases for the long run outcome.
 
     2. Fragmenting the amyloid proteins with long pulse infrared light is considered a break through approach.
 
     3. Antiinflmmatory substances during the laser treatment must be provided.
 
By having these steps working together you can certainly get rid of your lichen amyloidosis.
 
Thank to my patients that trust me and allow me to find the solution for this difficult skin problem that sadden many south east asian people.
 
Hope, you can find a doctor nearby who cares enough to help you instead of just doing Botox for your mom’s crowfeet lines.
 
 

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