Amyloidosis cutis dyschromica
A 26-year-old female presented with hyperpigmentation of skin since birth and progressively developed, hypo- and de-pigmented spotty macules over the extremities and trunk during childhood. She was born to parents of second-degree consanguineous marriage, with history of similar skin lesions in maternal uncle. Patient did not give any history of photosensitivity, blistering, itching or developmental delay.\nGeneral physical examination was normal. Cutaneous examination revealed diffuse hyperpigmentation with mottled spotty, well-defined, de-pigmented and hypopigmented macules ranging from pinpoint to 2 × 2 cm in size. Some of the de-pigmented macules were atrophic []. Her face and abdomen was relatively spared with involvement of the extremities. Hair, teeth, nails and oral mucosa were normal. Ophthalmology and ENT assessments were normal. Systemic examination was unremarkable.\nHistopathology of hypopigmented lesion showed atrophic epidermis with loss of rete ridges. The upper dermis revealed eosinophilic extracellular nodular deposits and mild perivascular aggregates of chronic inflammatory cells, of which lymphocytes predominate []. These eosinophilic deposits stained brick red with Congo Red stain [].\nHistopathology of the hyperpigmented lesion also showed eosinophilic deposits that stained brick red with Congo Red.\nAll other routine investigations were within normal limits.\nWith these findings, a diagnosis of ACD was made.