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Pruritic Papular Eruption

David D. Picascia, MD; Morgan L. Magid, MD; Ronald B. Minkin, MD
[+] Author Affiliations

Northwestern University Medical School, Chicago, Ill


Arch Dermatol. 1989;125(7):989-990. doi:10.1001/archderm.1989.01670190123019
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REPORT OF A CASE  A 36-year-old man presented with a pruritic eruption of 4 months' duration. It had started on the chest and upper back and later spread to the upper arms and forehead. He was otherwise in good health except for a history of peptic ulcer disease at age 22 years.Physical examination showed slightly hypopigmented papules on his chest, upper back, arms, and forehead (Figs 1 and 2). The lesions were confluent in certain areas. Results of initial laboratory examinations were as follows: normal white blood cell count and differential; normal hemoglobin and hematocrit; total serum protein, 87 g/L (normal, 57 to 82 g/L); albumin, 44 g/L (normal, 26 to 52 g/L); and globulin, 43 g/L (normal, 25 to 37 g/L).A skin biopsy specimen from a chest papule was stained with hematoxylin-eosin (Fig 3). Special stains were also performed (Fig 4).What is your diagnosi?

DIAGNOSIS:  Popular mucinosis (lichen myxedematosus)

HISTOPATHOLOGIC FINDINGS  A biopsy specimen of a papule was obtained. The epidermis

REFERENCES

Farmer ER, Hambrick GW Jr, Shulman LE.  Papular mucinosis: a clinicopathologic study of four patients . Arch Dermatol. 1982;;118:9-13.
Montgomery H, Underwood LJ.  Lichen myxedematosus (differentiation from cutaneous myxedemas or mucoid states) . J Invest Dermatol. 1953;;20:213-233.
Verbou JL, Borrie PF.  Scleromyxedema: a variant of lichen myxedematosus (papular mucinosis) . Br J Dermatol. 1969;;81:871-873.
Perry HO, Montgomery A, Stickney JM.  Further observations on lichen myxedematosus . Ann Intern Med. 1960;;53:955-969.
Chanda JJ.  Scleromyxedema . Cutis. 1979;;24:549-552.
Truhen AP, Roenigk HH Jr.  The cutaneous mucinoses . J Am Acad Dermatol. 1986;;14:1-18.
Harper RA, Rispler J.  Lichen myxedematosus serum stimulates human skin fibroblast proliferation . Science. 1978;;188:545-547.
Lever WF, Schaumburg-Lever G. Histopathology of the Skin . 6th ed. Philadelphia, Pa: JB Lippincott; 1983;:424-429.
Hill TG, Crawford JN, Rogers CC.  Successful management of lichen myxedematosus: report of a case . Arch Dermatol. 1976;;112:67-69.
Westheim AI, Lookingbill DP.  Plasmapheresis in a patient with scleromyxedema . Arch Dermatol. 1987;;123:786-789.
Hardie RA, Hunter JAA, Urbaniak S, Habeshaw JA.  Spontaneous resolution of lichen myxoedematosus . Br J Dermatol. 1979;;100:727-730.

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Farmer ER, Hambrick GW Jr, Shulman LE.  Papular mucinosis: a clinicopathologic study of four patients . Arch Dermatol. 1982;;118:9-13.
Montgomery H, Underwood LJ.  Lichen myxedematosus (differentiation from cutaneous myxedemas or mucoid states) . J Invest Dermatol. 1953;;20:213-233.
Verbou JL, Borrie PF.  Scleromyxedema: a variant of lichen myxedematosus (papular mucinosis) . Br J Dermatol. 1969;;81:871-873.
Perry HO, Montgomery A, Stickney JM.  Further observations on lichen myxedematosus . Ann Intern Med. 1960;;53:955-969.
Chanda JJ.  Scleromyxedema . Cutis. 1979;;24:549-552.
Truhen AP, Roenigk HH Jr.  The cutaneous mucinoses . J Am Acad Dermatol. 1986;;14:1-18.
Harper RA, Rispler J.  Lichen myxedematosus serum stimulates human skin fibroblast proliferation . Science. 1978;;188:545-547.
Lever WF, Schaumburg-Lever G. Histopathology of the Skin . 6th ed. Philadelphia, Pa: JB Lippincott; 1983;:424-429.
Hill TG, Crawford JN, Rogers CC.  Successful management of lichen myxedematosus: report of a case . Arch Dermatol. 1976;;112:67-69.
Westheim AI, Lookingbill DP.  Plasmapheresis in a patient with scleromyxedema . Arch Dermatol. 1987;;123:786-789.
Hardie RA, Hunter JAA, Urbaniak S, Habeshaw JA.  Spontaneous resolution of lichen myxoedematosus . Br J Dermatol. 1979;;100:727-730.

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