A case report of discrete papular subtype of lichen myxedematosus
Keywords:
primary cutaneous mucinosis, Discrete papular subtype of lichen myxedematosusAbstract
Lichen myxedematosus is a chronic, idiopathic disorder characterized by an abnormal accumulation of mucin in the skin. The localized variants of lichen myxedematosus are subdivided into four subtypes: (1) a discrete papular form; (2) acral persistent papular mucinosis; (3) cutaneous mucinosis of infancy; (4) a pure nodular form. We reported a case of 48-year-old female patient who presented with multiple discrete flat-topped whitish papules on the chest wall, upper back, both forearms, and dorsum of both hands and feet. The histopathology and special staining were compatible with lichen myxedematosus. Laboratory investigations for further systemic involvements were performed. Lichen myxedematosus is not associated with sclerosis, paraproteinemia, systemic involvement or thyroid disease. The disease has a good prognosis and does not require any treatment. Wait-and-see approach is recommended.
References
2. Rongioletti F, Rebora A. Mucinoses. In: Bolognia JL, Jorizzo JL, Schaffer JV, editors. Dermatology. 3rd ed. Elsevier Saunders: 2012: 691-2.
3. Rongioletti F, Rebora A. Updated classification of papular mucinosis, lichen myxedematosus, and scleromyxedema. J Am Acad Dermatol 2001;44:273- 81.
4. Farmer ER, Hambrick GW Jr, Shulman LE. Papular mucinosis. A clinicopathologic study of four patients. Arch Dermatol 1982;118:9-13.
5. Ruiz-Rodriguez R, Maurer TA, Berger TG. Papular mucinosis and human immunodeficiency virus infection. Arch Dermatol 1992;128:995-6.
6. Montesu MA, Cottoni F, Sanna R, Cerimele D. Lichen myxedematosus associated with chronic hepatitis C: a case report. Acta Derm Venereol 2001;81:67-8.
7. Rongioletti F, Rampini P, Parodi A, Rebora A. Papular mucinosis associated with generalized morphea. Br J Dermatol 1999;141:905-8. . Sáez-Rodriguez M, Garcia-Bustinduy M, López-Alba A, et al. Localized lichen myxoedematosus (papular mucinosis) associated with morbid obesity: report of two cases. Br J Dermatol 2003;148:165-8.
9. Martin-Ezquerra G, Sanchez-Regana M, Massana-Gil J, Umbert-Millet P. Papular mucinosis associated with subclinical hypothyroidism: improvement with thyroxine therapy. J Eur Acad Dermatol Venereol 2006;20:1340-1.
10. Rongioletti F, Rebora A. Cutaneous toxic mucinoses. J Am Acad Dermatol 1992;26:789-90.
11. Valicenti JM, Fleming MG, Pearson RW, Budz JP, Gendleman MD. Papular mucinosis in L-tryptophaninduced eosinophilia-myalgia syndrome. J Am Acad Dermatol 1991;25:54-8.
12. Walter HC, Bernhard Z. Metabolic diseases of the skin. In: Elder DE, editors. Lever's histopathology of the skin. 11th ed. Lippincott Williams & Wilkins: 2014: 637-9.
13. Sulit DJ, Harford R, O'Neill JT. Discrete papular form of lichen myxedematosus: a case report and review of the literature. Cutis 2005;75:105-12.
14. Montgomery H, Underwood LJ. Lichen myxedematosus; differentiation from cutaneous myxedemas or mucoid states. J Invest Dermatol 1953;20:213-36.
15. Woerdeman MJ. Is collagenome eruptif a separate entity? Br J Dermatol 1960;72:217-20.
16. Tay CH, Khoo OT. Papular mucinosis in chronic psoriatic erythroderma. Report of a case. Arch Dermatol 1970;102:304-8.
17. Coskey RJ, Mehregan A. Papular mucinosis. Int J Dermatol 1977;16:741-4.
18. Abd El-Aal H, Salem SZ, Salem A. Lichen myxedematosus: histochemical study. Dermatologica 1981;162:273-6.
19. Kaymen AH, Nasr A, Grekin RC. The use of carbon dioxide laser in lichen myxedematosus. J Dermatol Surg Oncol 1989;15:862-5.
20. Reynolds NJ, Collins CM, Burton JL. Discrete papular mucinosis responding to intralesional and topical steroids. Arch Dermatol 1992;128:857-8.
21. Rongioletti F, Rebora A. Worsening of lichen myxedematosus during interferon alfa-2a therapy for chronic active hepatitis C. J Am Acad Dermatol 1998;38:760-1.
22. Poswig A, Hinrichs R, Megahed M, Hunzelmann N, Kirchberg K, Brenneisen P, et al. Discrete papular mucinosis-a rare subtype of lichen myxoedematosus. Clin Exp Dermatol 2000;25:289-92.
23. Seike M, Ikeda M, Kodama H. Discrete papular mucinosis on the back. J Dermatol 2005;32:856-8.
24. Bragg J, Soldano AC, Latkowski JA. Papular mucinosis (discrete papular lichen myxedematosus). Dermatol Online J 2008;14:14.
25. Rongioletti F, Zaccaria E, Cozzani E, Parodi A. Treatment of localized lichen myxedematosus of discrete type with tacrolimus ointment. J Am Acad Dermatol 2008;58:530-2.
26. Concheiro J, Perez-Perez L, Peteiro C, Labandeira J, Toribio J. Discrete papular lichen myxoedematosus: a rare subtype of cutaneous mucinosis. Clin Exp Dermatol 2009;34:e608-10.
27. Hadj I, Gallouj S, Meziane M, Mernissi FZ. Discrete papular lichen myxedematosus: a rare entity or an under- diagnosed disease? Pan Afr Med J 2014;19:180.
28. Tam CC, Meier MJ. Discrete papular lichen myxedematosus with an unusual segmental presentation. Acta Dermatovenerol Croat 2014;22:224-6.
Downloads
Published
How to Cite
Issue
Section
License
เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใดๆ
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นลิขสิทธิ์ของวารสารฯ หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใดๆ จะต้องได้รับอนุญาตเป็นลายลักอักษรจากบรรณาธิการวารสารโรคผิวหนังก่อนเท่านั้น
