Localized lichen myxedematosus
- Franco Rongioletti, MD
Franco Rongioletti, MD
- Professor and Chairman
- Unit of Dermatology
- University of Cagliari, Italy
Lichen myxedematosus (LM, also called papular mucinosis) is a chronic idiopathic cutaneous mucinosis characterized by lichenoid papules, nodules, and/or plaques; mucin deposition and a variable degree of fibrosis in the dermis; and an absence of associated thyroid disease . LM includes three clinicopathologic subsets (table 1) [1,2]:
●Localized LM: A localized papular form of LM with a benign course and lack of systemic involvement.
●Scleromyxedema: A diffuse/generalized papular and sclerodermoid form of LM associated with monoclonal gammopathy and systemic, potentially fatal, manifestations. (See "Scleromyxedema".)
●Atypical or intermediate forms of LM: LM with atypical features or overlapping features of localized LM and scleromyxedema.
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- Jun JY, Oh SH, Shim JH, et al. Acral Persistent Papular Mucinosis with Partial Response to Tacrolimus Ointment. Ann Dermatol 2016; 28:517.
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- Rongioletti F, Rebora A. Cutaneous toxic mucinoses. J Am Acad Dermatol 1992; 26:789.
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- Rongioletti F, Ghigliotti G, De Marchi R, Rebora A. Cutaneous mucinoses and HIV infection. Br J Dermatol 1998; 139:1077.
- Abbott RA, Calonje E, Almaani N, et al. Widespread papules in a patient with human immunodeficiency virus. Papular mucinosis (PM) in association with HIV infection. Clin Exp Dermatol 2010; 35:801.
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- Hermans C, Goldscheider I, Ruzicka T, Rongioletti F. Atypical discrete papular lichen myxedematosus associated with monoclonal gammopathy: report of four cases and review of the literature. J Eur Acad Dermatol Venereol 2016; 30:2048.
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- 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.
- Rongioletti F, Rebora A. Cutaneous mucinoses: microscopic criteria for diagnosis. Am J Dermatopathol 2001; 23:257.
- Rongioletti F, Rebora A, Crovato F. Acral persistent papular mucinosis: a new entity. Arch Dermatol 1986; 122:1237.
- Barreau M, Dompmartin-Blanchère A, Jamous R, et al. Nodular lesions of self-healing juvenile cutaneous mucinosis: a pitfall! Am J Dermatopathol 2012; 34:699.
- Rongioletti F, Rebora A. Mucinous nevus. Arch Dermatol 1996; 132:1522.
- Depaire-Duclos F, Renuy F, Dandurand M, Guillot B. Papular mucinosis with rapid spontaneous regression in an HIV-infected patient. Eur J Dermatol 1998; 8:353.
- 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.
- André Jorge F, Mimura Cortez T, Guadalini Mendes F, et al. Treatment of acral persistent papular mucinosis with electrocoagulation. J Cutan Med Surg 2011; 15:227.
- Graves MS, Lloyd AA, Ross EV. Treatment of acral persistent papular mucinosis using an Erbium-YAG laser. Lasers Surg Med 2015; 47:467.
- Ballina García FJ, Martin Lascuevas P, Iglesias García A, et al. [Fibromyalgia. Clinical review]. Rev Clin Esp 1995; 195:326.
- ASSOCIATED CONDITIONS
- CLINICAL FINDINGS
- Acral persistent papular mucinosis
- Discrete papular lichen myxedematosus
- Cutaneous mucinosis of infancy
- Nodular lichen myxedematosus
- Skin biopsy
- Laboratory tests
- DIFFERENTIAL DIAGNOSIS
- PROGNOSIS AND FOLLOW-UP
- SUMMARY AND RECOMMENDATIONS