Acral persistent papular mucinosis (APPM) is a rare subtype of localized lichen
myxedematosus. It consists of small papules localized exclusively on the back of
the hands, wrists and extensor aspects of distal forearms with no other clinical
or laboratory manifestations. The lesions tend to persist and may increase
slowly in number. Histologically, hematoxylin-eosin and Alcian blue staining
demonstrate mucin accumulation in the upper reticular dermis with separation of
collagen fibers as a result of hyaluronic acid deposition. Treatment is rarely
necessary due to the absence of symptoms. We present a 27-year-old healthy woman
with asymptomatic papules on her upper extremities, which adequately meet
clinical and pathological criteria of acral papular mucinosis.