a case of lichen myxedematosus by Dr/ Rania Alakad describing the clinical and histological findings of the disease.

2.  55 ♀ patient.
 Skin lesions, 4
months duration on
the neck then
progressed to
involve the upper
chest.
 Mild itching.
 No systemic
affection
 Irrelevant medical
history

6.  CBC
 RFT – LFT
 Random blood sugar.
 Pelvi-abdominal US.

7.  Sarcoidosis
 Papular mucinosis.
 Xanthomas
 Pseudoxanthoma elasticum,

11. Papular mucinosis
(Lichen
myxedematosus )

12.  Papular mucinosis is a primary form of
cutaneous mucinosis characterized by an
abnormal deposition of mucin in the skin.
Divided into:
 Generalized (scleromyxedema).
 Localized forms.

13.  Increased certain serum cytokines ( IL1,
TNFα , TGFβ ) and immunoglobulins were
hypothesized to cause fibroblasts
proliferation and increased mucin
deposition in the skin.
 the disease is commonly associated with
monoclonal gammopathy paraproteinemia.

14. a generalized form
(scleromyxedema):
1. Papular
lesions.
2. Sclerodermoid
features.
1. Paraproteinemia .
2. systemic
manifestations.

15.  The localized form:
papules, nodules and plaques that are skin
colored, waxy and asymptomatic
 No sclerosis.
 No paraproteinemia
 No systemic involvement

16. This localized type is divided into five
subtypes:
1) the discrete papular form.
2) acral persistent papular mucinosis.
3) spontaneous self healing mucinosis
4) cutaneous mucinosis of infancy.
5) the purely nodular form.

19. • Localized papular
lesions.
• No systemic
affection.
• No paraproteinemia.
• Spontaneous self
healing.

20.  Topical:
 Tacrolimus
 Betamethasone
 (DMSO)
 Retinoids
 Systemic:
 Corticosteroids,
Thalidomide, Interferon,
Retinoids ,
Plasmapheresis, ECP,
Immunoglobulin
 Melphalan chemotherapy
with autologous stem
cell transplantation

21. Papular
mucinosis
Paraprotein
Papules
Blue