“…3,4 Acral papular mucinosis was initially recognized in the early 1990s and has since been a subject of intrigue for dermatologists and researchers alike. It is a rare subtype of localized lichen myxedematosus and the literature suggested its association with monoclonal gammopathy [5][6][7][8] ; however, the exact etiology is unknown. Several studies suggested the association of this entity with an immunologic response to an unknown antigenic stimulus.…”