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September 2002

Erythematous Rash on the Chest

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Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2002

Arch Dermatol. 2002;138(9):1245-1250. doi:10.1001/archderm.138.9.1245

The hematoxylin-eosin–stained biopsy specimen revealed a normal epidermis and a deep perivascular and periadnexal infiltrate of lymphocytes. Alcian blue staining showed the separation of the collagen fibers by mucin.

In 1960, Perry et al1 reported a unique type of mucinosis with a predilection for the thorax and gave it the name plaque-like mucinosis. In the early 1970s, Steigleder et al2 reported 4 cases with a sheetlike or netlike erythema that affected the upper part of the chest or back. They found no evidence of lupus erythematosus, metabolic disease, or hematologic disease. All 4 patients responded to treatment with antimalarial agents. Steigleder and colleagues called this condition REM syndrome. It is now believed that REM syndrome and plaque-like cutaneous mucinosis are both part of the same disease spectrum.3