Normal epidermis and widely separated collagen fibers demonstrated in histo- pathological examination. 

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... mucinoses are a wide group of disorders characterized by anomalous deposits of mucin in the skin. Lichen myxoedematosus can be classifi ed into several subtypes, depending on the distribution and overall skin involvement. Discrete papular lichen myxoedematosus (DPLM) is an uncommon subtype of primary cutaneous mucinoses. Only fi ve of the cases described in the literature to date showed no relation with systemic diseases. Herein, we report the fi rst case of a patient with discrete white papules with mucin deposition that appeared localized to the back. A 49-year-old woman was referred to our department with asymptomatic papules of 3 months’ duration on the upper back. Physical examination revealed numer- ous 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. Histo- pathological 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 inef- fective. Because the patient was asymptomatic, we preferred to follow conservatively. During the follow- up of 20 months, we did not observe any evidence of spontaneous resolution or progression. Cutaneous mucinoses are a wide group of disorders characterized by anomalous deposits of mucin in the skin 1 . Lichen myxoedematosus can be classifi ed into several subtypes, depending on the distribution and overall skin involvement. Discrete papular lichen myxoedematosus (DPLM) is an uncommon subtype of primary cutaneous mucinoses 2 . Papular mucinosis is a rare and chronic disorder which was described by Montgomery and Underwood in 1953 3 . Th e cutaneous focal mucinoses are a group of connective tissue disorders characterized by deposition of mucin found in the middle and deeper layers of the dermis, displacing collagen fi bers but not involving the dermal papillae or accumulating around blood vessels 4 . Rongioletti et al. suggested that lichen myxoedematosus included clinic-pathological subsets: a generalized papular and sclerodermoid form with systemic eff ects (also called scleromyxedema) and localized papular forms without systemic eff ects. Th e localized papular subtype was further subdivided into acral persistent papular mucinosis, papular mucinosis of infancy, self- healing papular mucinosis and a discrete papular or nodular form 2–5 . We classifi ed our patient as the discrete papular form. Th e pathophysiology of cutaneous mucinosis is not well-known. Cytokines, paraproteins, chronic antigen- ic stimulation, viral infections, and infl ammation may contribute to the pathogenesis. DPLM is a very uncommon type of cutaneous primary mucinosis, which aff ects both genders equally. Th ere have been only fi ve cases unrelated to systemic diseases reported previously in the literature. Lesions are usu- ally found on the face, neck, trunk or extremities in a symmetrical pattern. Lesions are fl esh-colored to ery- thematous, smooth surfaced and approximately 2–5 mm in diameter. To the best of our knowledge, this is the fi rst case of discrete papular mucinosis with white colored papules ever reported in the literature. Cutaneous eruptions may be generalized or localized in papular mucinosis. Systemic organ dysfunction does not occur in localized papular mucinosis. Th ere was no organ involvement in our patient. Th e treatment of mucinosis is diffi cult. Spontaneous healing has rarely been observed. As it is limited to the skin and has little or no morbidity, no systematic treatment approach is an acceptable option 5 . Transition to scleromyxedema has not yet been reported. In conclusion, we report a case of DPLM in an other- wise healthy woman. Th e results of clinical examinations and laboratory tests were all negative for con- ditions typically associated with mucin deposition disorders and our patient had no improvement in her lesions during the follow-up of 20 ...