Discrete papular lichen myxedematosus
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| field = Dermatology
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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..{{cite book | vauthors = Rapini RP, Bolognia JL, Jorizzo JL |title=Dermatology: 2-Volume Set | edition = 2nd |publisher=Mosby |location=St. Louis |year=2007 |isbn=978-1-4160-2999-1 }}{{cite book | vauthors = James WD, Berger TG, Elston DM, Neuhaus IM, Micheletti RG | chapter = Chapter 9: Mucinoses: Lichen Myxedematosus | pages = 179–182 | title = Andrews' Diseases of the Skin: Clinical Dermatology | location = Philadelphia |publisher=Saunders Elsevier |year=2016 |isbn=978-0-323-31967-6 | edition = 12th }}
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.{{cite journal | vauthors = Hadj I, Gallouj S, Meziane M, Mernissi FZ | title = Discrete papular lichen myxedematosus: a rare entity or an under- diagnosed disease? | journal = The Pan African Medical Journal | volume = 19 | pages = 180 | year = 2014 | pmid = 25815101 | pmc = 4366121 | doi = 10.11604/pamj.2014.19.180.5389 }}
Causes
This disease's etiology is still unknown.{{cite journal | vauthors = Rongioletti F, Rebora A | title = Updated classification of papular mucinosis, lichen myxedematosus, and scleromyxedema | journal = Journal of the American Academy of Dermatology | volume = 44 | issue = 2 | pages = 273–281 | date = February 2001 | pmid = 11174386 | doi = 10.1067/mjd.2001.111630 | publisher = Elsevier BV }}
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.
Treatment
Numerous therapies have been attempted, with varying degrees of success, such as dermabrasion, CO2 laser, intralesional injections of corticosteroids or hyaluronidase, oral retinoids, psoralen ultraviolet A, and pimecrolimus.{{cite journal | vauthors = Concheiro J, Pérez-Pérez L, Peteiro C, Labandeira J, Toribio J | title = Discrete papular lichen myxoedematosus: a rare subtype of cutaneous mucinosis | journal = Clinical and Experimental Dermatology | volume = 34 | issue = 8 | pages = e608–e610 | date = December 2009 | pmid = 19486062 | doi = 10.1111/j.1365-2230.2009.03294.x | publisher = Oxford University Press (OUP) | s2cid = 20660876 }} 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.{{cite journal | vauthors = Rongioletti F, Zaccaria E, Cozzani E, Parodi A | title = Treatment of localized lichen myxedematosus of discrete type with tacrolimus ointment | journal = Journal of the American Academy of Dermatology | volume = 58 | issue = 3 | pages = 530–532 | date = March 2008 | pmid = 18280368 | doi = 10.1016/j.jaad.2006.10.021 | publisher = Elsevier BV }}
See also
References
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External links
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| ICD11 = {{ICD11|EB90.1}}
| ICD10 = {{ICD10|L98.5}}
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