Amyloid Lichen: Efficacy of Combination Therapy with UVB-BE Phototherapy and a 1064-nm Q-switched Nd: YAG Laser- A Case Report

Abstract

Background: Lichen amyloidosis is a chronic, pruritic dermatosis characterised by hyperkeratotic papules and amyloid deposition in the papillary dermis. Treatment may be challenging when symptoms and lesions persist despite conventional topical therapy. Aim: This case describes the clinical course following combined narrowband ultraviolet B (NB-UVB) phototherapy and a 1064-nm Q-switched Nd laser, alongside topical treatment. Case Presentation: A 51-year-old woman presented with bilateral, symmetrical, hyperpigmented and hyperkeratotic papules coalescing into plaques over the pretibial regions, accompanied by intense pruritus. The symptoms had begun in 2020, and she attended dermatology services in February 2026. Her Fitzpatrick skin phototype was IV/VI. Dermatoscopy showed central white areas and peripheral grey globules on a brown background. Histopathological examination and Congo red staining supported a diagnosis of lichen amyloidosis. Treatment included 0.05% clobetasol propionate, 20% urea emollient, petroleum jelly, twice-weekly NB-UVB phototherapy for 24 sessions and five Q-switched Nd laser sessions at three-week intervals. Mild, transient erythema was observed following treatment. After 12 weeks, the patient exhibited partial flattening of papules and improvement in hyperpigmentation. Her pruritus score on a 0–10 visual analogue scale decreased from 10 to 0. Conclusion: Clinical improvement was observed during multimodal treatment. This single case cannot determine the contribution of individual interventions or establish long-term efficacy.