Ann Dermatol.  2008 Dec;20(4):233-236. 10.5021/ad.2008.20.4.233.

Papular Mucinosis Associated with Systemic Lupus Erythematosus

• Lee WJ
• Park GH
• Chang SE
• Lee MW
• Choi JH
• Moon KC
• Koh JK

• KMID: 2156402
• DOI: http://doi.org/10.5021/ad.2008.20.4.233

Abstract

Papulonodular mucinosis (PNM) is a rare variant of lupus erythematosus (LE) eruptions, and PNM is characterized histologically by diffuse dermal mucin without any typical epidermal inflammatory changes. We herein describe a case of papular mucinosis that was characterized by several erythematous papules on the lower back of a 32-year-old man with systemic LE. It is interesting that he didn't display any other skin manifestations of LE such as malar rash, discoid rash and photosensitivity during the previous 2 years. He achieved remission of his PNM without recurrence after 5 months treatment with topical steroids, in addition to receiving systemic antimalarials and steroids.

Keyword

Papulonodular mucinosis; Systemic lupus erythematosus

MeSH Terms

Adult
Antimalarials
Exanthema
Humans
Lupus Erythematosus, Systemic
Mucinoses
Mucins
Recurrence
Scleromyxedema
Skin Manifestations
Steroids
Antimalarials
Mucins
Steroids

Figure

• 

  Fig. 1 Multiple, relatively well-demarcated, flesh or erythematous colored papules on the lower back.

• 

  Fig. 2 A skin biopsy specimen showing (A) intact epidermis, deposition of basophilic mucinous materials and scant infiltration of mononuclear cells in the dermis (H&E, ×ndles and around the sweat glands (H&E, ×100). (C) Alcian blue staining (pH 2.5) showing the deposits of mucin in the dermis (×40).

Reference

1. Gold SC. An unusual papular eruption associated with lupus erythematosus. Br J Dermatol. 1954; 66:429–433.

2. Park J, Park CO, Lee KH. Papulonodular mucinosis associated with systemic lupus erythematosus: cutaneous lupus mucinosis. Korean J Dermatol. 2004; 42:1073–1075.

3. Sonntag M, Lehmann P, Megahed M, Ruzicka T, Kuhn A. Papulonodular mucinosis associated with subacute cutaneous lupus erythematosus. Dermatology. 2003; 206:326–329.

4. Lowe L, Rapini RP, Golitz LE, Johnson TM. Papulonodular dermal mucinosis in lupus erythematosus. J Am Acad Dermatol. 1992; 27:312–315.

5. Choi EH, Hann SK, Chung KY, Park YK. Papulonodular cutaneous mucinosis associated with systemic lupus erythematosus. Int J Dermatol. 1992; 31:649–652.

6. Kanda N, Tsuchida T, Watanabe T, Tamaki K. Cutaneous lupus mucinosis: a review of our cases and the possible pathogenesis. J Cutan Pathol. 1997; 24:553–558.

7. Williams WL, Ramos-Caro FA. Acute periorbital mucinosis in discoid lupus erythematosus. J Am Acad Dermatol. 1999; 41:871–873.

8. Kobayashi T, Shimizu H, Shimizu S, Harada T, Nishikawa T. Plaquelike cutaneous lupus mucinosis. Arch Dermatol. 1993; 129:383–384.

9. Kano Y, Sagawa Y, Yagita A, Nagashima M. Nodular cutaneous lupus mucinosis: report of a case and review of previously reported cases. Cutis. 1996; 57:441–444.

10. Pandya AG, Sontheimer RD, Cockerell CJ, Takashima A, Piepkorn M. Papulonodular mucinosis associated with systemic lupus erythematosus: possible mechanisms of increased glycosaminoglycan accumulation. J Am Acad Dermatol. 1995; 32:199–205.