Abstract: 【Abstract】 Objective To investigate the reflectance confocal microscopic features of primary cutaneous amyloidosis. Methods A total of 30 outpatients with confirmed primary cutaneous amyloidosis were enrolled from Department of Dermatology, Hangzhou Third People′s Hospital between June 2015 and October 2016. Their lesions were observed by reflectance confocal microscopy （RCM）, and subjected to histopathological examination. Results RCM imaging of primary cutaneous amyloidosis lesions showed hyperkeratosis in 22 cases, acanthosis in 15, hyperpigmentation in the basal cell layer in 20, incontinence of pigment in the dermal papilla and superficial dermis in 20, and enlarged polymorphous dermal papilla with highly refractive clumps in 30. These RCM features were highly consistent with histopathological findings. Conclusion The typical RCM characteristic of primary cutaneous amyloidosis is highly refractive clumps in the dermal papilla, and RCM may serve as a non-invasive tool for assisting diagnosis of primary cutaneous amyloidosis.

Key words: Amyloidosis, Microscopy, confocal