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October 1990

Acral Persistent Papular Mucinosis: A Peculiar Variant of the Discrete Papular Form of Lichen Myxedematosus

Author Affiliations

Department of Dermatology Universitair Ziekenhuis De Pintelaan 185 B-9000 Ghent, Belgium

Arch Dermatol. 1990;126(10):1372-1374. doi:10.1001/archderm.1990.01670340124031

To the Editor.—  At the 1985 meeting of the Belgian Dermatological Society in Ghent, Belgium, we presented the case of a 66-year-old woman with a chronic, almost asymptomatic papular eruption on the extensor side of the distal third of the forearms and on the dorsa of the hands. Histologicexamination of a papule disclosed mucin in the reticular dermis. No evidence was found for paraproteinemia or thyroid disease. Our diagnosis was papular mucinosis (synonym, lichen myxedematosus).1In 1986, two articles were published in which the patients were described as having exactly the same clinical features as our patient; the authors argued that all three patients had the same disease and they introduced the diagnosis acral persistent papular mucinosis (APPM).2Five other cases have been published since (reviewed in references 3 and 4). We present our second case of this apparently not so uncommon entity, and discuss its relationship with lichen

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