Atypical discrete papular lichen myxedematosus associated with monoclonal gammopathy: report of four cases and review of the literature

Abstract

Our experience indicates an excellent prognosis of DPLM even for atypical cases in spite of the presence of monoclonal gammopathy.

Lichen myxedematosus associated with monoclonal gammopathy of undetermined significance: A case report and literature review

“…There is no need for treatment for localized forms of LM, and a wait-and-see approach is recommended (1,(6)(7)(8). In terms of treatment for scleromyxedema, intravenous immunoglobulin, systemic glucocorticoids, thalidomide, autologous stem cell transplantation and other therapies have been reported (9).…”

Skin-Colored Papules on the Right Lower Back of an Elderly Man

“…Histopathologically, focal or diffuse mucin deposition interspersed with large collagen bundles can be seen in the upper dermis and mid dermis, with variable degrees of fibroblast proliferation and perivascular lymphocytic infiltration. 5 Overstimulation of fibroblasts by circulating cytokines, viral infections, surgical procedures, trauma, and radiotherapy may play a role in the pathogenesis of lichen myxedematosus. 6,7 Papular mucinosis may be associated with HIV and other chronic viral infections.…”

“…Papular mucinosis is a form of localized lichen myxedematosus characterized by firm, smooth, waxy, skin-colored to red papules on the trunk and limbs, usually in a symmetrical pattern. Histopathologically, focal or diffuse mucin deposition interspersed with large collagen bundles can be seen in the upper dermis and mid dermis, with variable degrees of fibroblast proliferation and perivascular lymphocytic infiltration . Overstimulation of fibroblasts by circulating cytokines, viral infections, surgical procedures, trauma, and radiotherapy may play a role in the pathogenesis of lichen myxedematosus .…”

Lichen Myxedematosus: Case Report and Review of Literature

“…Fibroblast overstimulation of IL-1, TNF-a, and TGF-beta has been proposed. 5 There is no definitive treatment due to its poorly understood pathogenesis. Intravenous immunoglobulin has proven more effective than corticosteroids for both cutaneous and extracutaneous manifestations.…”

“…Discrete LM is also associated with Hepatitis C. 1,2,6 It has been proposed that HIV stimulates mucin and collagen production in LM. 5 Acral persistent papular mucinosis is more common in females (4.7:1) and presents with multiple ivory to flesh colored papules exclusively on the dorsal hands, extensor surface of the wrists, and occasionally the distal forearms. 2 Self-healing papular mucinosis is divided into juvenile and adult variants.…”