Discrete papular lichen myxoedematosus: A case report

Abstract

Case ReportA 49-year-old woman was referred to our department with asymptomatic papules of 3 months' duration on the upper back. Physical examination revealed numerous well-defi ned, white papules, 3-5 mm in diameter (Figure 1). Th ere wasn't any induration or thickening of the skin on the aff ected site. In addition, there was no history of preceding trauma and the patient was not taking any medication.Routine laboratory studies were unremarkable. Serum electrophoresis and thyroid function tests were normal. Screening for viral infections remained negative. General physical examination did not reveal any systemic involvement.A 4-mm punch biopsy was performed from one of the lesions located on the upper part of the back. Histopathological examination showed normal epidermis and widely separated collagen fi bers (Figure 2). PAS + Alcian Blue staining showed an increase in blue staining, which indicated an increase in dermal mucin (Figure 3). Based on the clinical, histological and laboratory fi ndings we have diagnosed the discrete papular type of lichen myxoedematosus.Although topical corticosteroids had been previously administered for three months, they had been ineffective. Because the patient was asymptomatic, we preferred to follow conservatively. During the followup of 20 months, we did not observe any evidence of spontaneous resolution or progression.