Asymptomatic papules and nodules on forehead and limbs

Abstract

A 3-year-old boy presented with a 3-month history of multiple asymptomatic skin lesions on his forehead and limbs, which had been increasing in number. No associated fever or any systemic symptoms were noted. The child was otherwise healthy and on no medications. He had been born after an uncomplicated pregnancy and delivery, and his growth and development were appropriate for his age. On physical examination, multiple skin-coloured to erythematous, mildly tender papules and nodules, 10-30 mm, were found, mainly on the forehead, the proximal interphalangeal joints, and the periarticular areas near the elbow and knee joints (Fig. 1). Except for mild erythema, the overlying skin was normal. No other abnormalities were found. Laboratory studies, including haematological and blood chemistry tests, anti-streptolysin O titre, erythrocyte sedimentation rate, serum and urine protein electrophoresis, urinalysis, and levels of C-reactive protein, liver transaminases, serum aldolase, creatinine, thyroid-stimulating hormone and antinuclear antibodies were all within normal limits. A skin biopsy specimen was obtained from a nodule over the elbow (Fig. 2).

Painless Symmetric Thickening of Proximal Interphalangeal Joints in an Adolescent Girl: Answer

“…pachydermodactyly needs to be differentiated from several entities that can mimic it clinically and histopathologically, such as knuckle pads, lichen simplex chronicus, dermatomyositis, systemic sclerosis, self-healing juvenile cutaneous mucinosis, juvenile idiopathic arthritis, and Thiemann disease. [1][2][3][4][5][6][7] Knuckle pads, termed Garrod pads in violinists and pseudo-knuckle pads in children, are skin callosities of the hands and fingers that may mimic pachydermodactyly histologically. However, knuckle pads, unlike pachydermodactyly, tend to affect the extensor and dorsal surface of the fingers and hands.…”

New Developmental Pattern of Lesions in Alcohol - Related Adult - Type Self - Healing Cutaneous Mucinosis: A Short Report and Review of the Literatures

“…The skin manifestations are mainly characterized by sudden onset of asymptomatic papules and nodules on different cutaneous locations; mostly on the face, peri -articular areas, and the abdomen (15). One of the main unique features of SHJCM is complete resolution within weeks to months, although in some cases, the course may be longer (16).…”

“…Cutaneous mucinosis has various clinical types, such as SHJCM and congenital forms (13). In previous studies, different types of SHJCM, such as the nodular type (14)(15)(16), focal type (6,17), familial type (10), recurrent type (18) with different lesion site presentation (1,15), have been report. Proper approach to this disorder and its mimickers have been presented (3,19,20).…”

A case of self-healing juvenile cutaneous mucinosis

“…The deeper nodules have been less often described but tend to have mucinous areas in the mid and deep reticular dermis, arborizing thin-walled vessels, and prominent plump to spindle-shaped fibroblasts [8]. Nodules may also contain large epithelioid ganglion-like mononuclear cells embedded in a myxoid stroma [4,11]. Immunohistochemical stains are negative for cytokeratin, epithelial membrane antigen, muscle actin and CD34 [11].…”

“…Nodules may also contain large epithelioid ganglion-like mononuclear cells embedded in a myxoid stroma [4,11]. Immunohistochemical stains are negative for cytokeratin, epithelial membrane antigen, muscle actin and CD34 [11].…”