Discrete papular lichen myxoedematosus: a rare subtype of cutaneous mucinosis

Abstract

Primary cutaneous mucinoses are characterized by abnormal mucin deposits in the skin. Discrete papular lichen myxoedematosus (DPLM) is an unusual subtype. Only 11 of the cases described in the literature to date showed no relation to human immunodeficiency virus (HIV) infection. We report a 21-year-old woman with numerous symmetrical asymptomatic papules on her trunk, arms and thighs. Results of investigations were normal. On histological examination, the upper dermis showed a focal mucin deposit. DPLM can be associated with HIV or C hepatitis virus (HCV) infection and therefore an early diagnosis is very important.

Localized Papular Mucinosis With IgA Nephropathy

“…Discrete PM is inappropriate because it is characterized by isolated papules, which present in a symmetric disposition, mainly on the trunk and extremities. [5][6][7] The manifestation of this form is clearly different from our case. It is also necessary to differentiate our patient's condition from mucinous nevus and SHPM.…”

Mucinous Nevus

“…Generalized subtypes of lichen myxedematosus have an associated monoclonal gammopathy, while discrete papular lichen myxedematosus, a variant of the localized subtype, has been associated with human immunodeficiency virus disease. 6 Other histologic mimics, like self-healing papular mucinosis and acral persistent papular mucinosis, are easily excluded with clinical information. In our case, clinical correlation confirmed the rare diagnosis of mucinous nevus.…”

Discrete (‘acral nonpapular’) localised lichen myxedematosus

“…1 DPLM presents as a chronic eruption of red or flesh-coloured 2-5 mm papules, symmetrically involving the limbs and trunk. It is seen equally in both genders and is histologically characterised by diffuse mucin deposition in the upper and middermis, with slight lymphocytic infiltration and fibroblast proliferation.…”

“…Its histopathology shows only focal dermal mucin deposition with sparing of the subepidermal zone (Grenz zone) and no increase in fibroblasts. [1][2][3] We report a case of a healthy patient who presented with a 7-year history of scaly plaques on the dorsal hands with finger swelling. Physical examination revealed multiple 5-10 mm pink scaly plaques overlying the metacarpophalangeal and proximal interphalangeal joints, and dorsal hands (figure 1).…”