Ann Dermatol.  2010 May;22(2):194-195. 10.5021/ad.2010.22.2.194.

A Case of Herpetiform Appearance of Digital Mucous Cysts

• Hur J
• Kim YS
• Yeo KY
• Kim JS
• Yu HJ

• KMID: 2265392
• DOI: http://doi.org/10.5021/ad.2010.22.2.194

Abstract

A digital mucous cyst (DMC) is clinically characterized by a round to oval, translucent, smooth nodule localized to the dorsal aspect of the distal digits near the distal interphalangeal joint. It usually presents as a solitary lesion, and multiple lesions are uncommon. An 88-year-old man presented with herpetiform translucent papules on the right thumb. We first diagnosed the lesion as molluscum contagiosum or herpetic whitlow. Histopathology showed a cystic space containing mucinous material and numerous fibroblasts surrounded by mucinous stroma in the upper dermis. The lining of the cyst wall was not apparent and mucinous material was stained with Alcian blue, indicating a diagnosis of DMC.

Keyword

Digital mucous cysts; Herpetiform

MeSH Terms

Aged, 80 and over
Alcian Blue
Chlorobenzenes
Dermis
Fibroblasts
Humans
Joints
Molluscum Contagiosum
Mucins
Thumb
Alcian Blue
Chlorobenzenes
Mucins

Figure

• 

  Fig. 1 Several small, round to oval, shiny, dome-shaped, whitish papules presenting as herpetiform lesions on the right thumb.

• 

  Fig. 2 Cystic space containing clear mucinous material in the dermis (H&E, ×40).

Reference

1. Hyde JN. A practical treatise on diseases of the skin, for the use of students and practitioners. 1883. Philadelphia: Lea & Febiger;423.

2. Hernandez-Lugo AM, Dominguez-Cherit J, Vega-Memije ME. Digital mucoid cyst: the ganglion type. Int J Dermatol. 1999. 38:533–535.

3. Karrer S, Hohenleutner U, Szeimies RM, Landthaler M. Treatment of digital mucous cysts with a carbon dioxide laser. Acta Derm Venereol. 1999. 79:224–225.

4. Miller PK, Roenigk RK, Amadio PC. Focal mucinosis (myxoid cyst). Surgical therapy. J Dermatol Surg Oncol. 1992. 18:716–719.

5. Salasche SJ. Myxoid cysts of the proximal nail fold: a surgical approach. J Dermatol Surg Oncol. 1984. 10:35–39.

6. Armijo M. Mucoid cysts of the fingers. Differential diagnosis, ultrastructure, and surgical treatment. J Dermatol Surg Oncol. 1981. 7:317–322.

7. de Berker D, Lawrence C. Ganglion of the distal interphalangeal joint (myxoid cyst): therapy by identification and repair of the leak of joint fluid. Arch Dermatol. 2001. 137:607–610.

8. Connolly M, de Berker DA. Multiple myxoid cysts secondary to occupation. Clin Exp Dermatol. 2006. 31:404–406.

9. Kivanc-Altunay I, Kumbasar E, Gokdemir G, Koslu A, Tekkesin M, Basak T. Unusual localization of multiple myxoid (mucous) cysts of toes. Dermatol Online J. 2004. 10:23.