Acral persistent papular mucinosis: a peculiar variant of the discrete papular form of lichen myxedematosus

Acral Persistent Papular Mucinosis and IgA Monoclonal Gammopathy: Report of a Case

“…A moderate increase in dermal fibroblasts may be observed [3,7,10], The mucinous material stains with alcian blue at pH 4.5 or pH 2.5, but not at pH 0.5, and is metachromatic with toluidine blue, in keeping with the presence of hyaluronic acids. Ultrastructural studies showed in 2 cases features similar to those observed in other cutaneous mucinoses [6,9]. There were large empty dermal spaces between the collagen fiber bundles with rather abundant networks of microfibrils, enclosing in some areas a finely granular amorphous substance.…”

“…[2] focusing on the distinctive features of APPM, at least 7 additional cases fitting the entity of APPM have been described [3][4][5][6][7][8][9]. APPM is characterized by the presence of multiple, fleshcolorcd, ivory or translucent papules of 2-5 mm in diam eter.…”

“…There were large empty dermal spaces between the collagen fiber bundles with rather abundant networks of microfibrils, enclosing in some areas a finely granular amorphous substance. Some collagen bundles were split by microfibrils or a granular substance, otherwise they were observed aggregated to the microfibril network [6,9].…”

“…It affects middle-aged persons with a female predominance [2][3][4][5][6][7][8][9]11], No consistent association with systemic disor ders, including thyroid disease, has been described to date [3,11 ]. although 1 patient died of a concomitant breast can cer [8].…”

Acral Persistent Papular Mucinosis and Lichen myxedematosus

“…Such a fre quency, however relative, depends on peculiar clinical and histopathological presentations of APPM that facilitate its identification and justify the suggestion of Naeyaert et al [3] to retain the term APPM in any case.…”