Discrete papular lichen myxedematosus

Discrete papular lichen myxedematosus
Specialty	Dermatology

Discrete papular lichen myxedematosus is a skin condition caused by fibroblasts producing abnormally large amounts of mucopolysaccharides characterized by the occurrence of waxy, flesh-colored papules.. ^{[1] [2]}

Signs and symptoms

Discrete papular lichen myxedematosus is typically identified by the presence of violaceous, flesh-colored, or reddish, waxy papules that range in size from 2 to 5 mm and that symmetrically affect the trunk and limbs. ^[3]

Causes

This disease's etiology is still unknown. ^[4]

Diagnosis

Histologically, a normal epidermis is covered by a diffuse or focal mucinous deposit and edema in the upper and mid dermis. Although there isn't any sclerosis or collagen deposition, fibroblast proliferation varies. ^[3]

Treatment

Numerous therapies have been attempted, with varying degrees of success, such as dermabrasion, carbon-dioxide laser, intralesional injections of corticosteroids or hyaluronidase, oral retinoids, psoralen ultraviolet A, and pimecrolimus. ^[5] Given its ability to inhibit both tumor necrosis factor-a and transforming growth factor-b, thus decreasing the synthesis of glycosaminoglycans by fibroblasts, topical tacrolimus 0.1% has recently been proposed as an effective substitute. ^[6]

See also

• Papular mucinosis
• List of cutaneous conditions

References

1. Rapini RP, Bolognia JL, Jorizzo JL (2007). Dermatology: 2-Volume Set (2nd ed.). St. Louis: Mosby. ISBN   978-1-4160-2999-1.
2. James WD, Berger TG, Elston DM, Neuhaus IM, Micheletti RG (2016). "Chapter 9: Mucinoses: Lichen Myxedematosus". Andrews' Diseases of the Skin: Clinical Dermatology (12th ed.). Philadelphia: Saunders Elsevier. pp. 179–182. ISBN   978-0-323-31967-6.
3. Hadj I, Gallouj S, Meziane M, Mernissi FZ (2014). "Discrete papular lichen myxedematosus: a rare entity or an under- diagnosed disease?". The Pan African Medical Journal. 19: 180. doi:10.11604/pamj.2014.19.180.5389. PMC   4366121 . PMID   25815101.
4. Rongioletti F, Rebora A (February 2001). "Updated classification of papular mucinosis, lichen myxedematosus, and scleromyxedema". Journal of the American Academy of Dermatology. 44 (2). Elsevier BV: 273–281. doi:10.1067/mjd.2001.111630. PMID   11174386.
5. Concheiro J, Pérez-Pérez L, Peteiro C, Labandeira J, Toribio J (December 2009). "Discrete papular lichen myxoedematosus: a rare subtype of cutaneous mucinosis". Clinical and Experimental Dermatology. 34 (8). Oxford University Press (OUP): e608 –e610. doi:10.1111/j.1365-2230.2009.03294.x. PMID   19486062. S2CID   20660876.
6. Rongioletti F, Zaccaria E, Cozzani E, Parodi A (March 2008). "Treatment of localized lichen myxedematosus of discrete type with tacrolimus ointment". Journal of the American Academy of Dermatology. 58 (3). Elsevier BV: 530–532. doi:10.1016/j.jaad.2006.10.021. PMID   18280368.