Discrete papular lichen myxedematosus explained

Field:	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, CO2 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

Notes and References

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