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July 1989

Pruritic Papular Eruption

Author Affiliations

Northwestern University Medical School, Chicago, Ill

Arch Dermatol. 1989;125(7):989-990. doi:10.1001/archderm.1989.01670190123019

REPORT OF A CASE  A 36-year-old man presented with a pruritic eruption of 4 months' duration. It had started on the chest and upper back and later spread to the upper arms and forehead. He was otherwise in good health except for a history of peptic ulcer disease at age 22 years.Physical examination showed slightly hypopigmented papules on his chest, upper back, arms, and forehead (Figs 1 and 2). The lesions were confluent in certain areas. Results of initial laboratory examinations were as follows: normal white blood cell count and differential; normal hemoglobin and hematocrit; total serum protein, 87 g/L (normal, 57 to 82 g/L); albumin, 44 g/L (normal, 26 to 52 g/L); and globulin, 43 g/L (normal, 25 to 37 g/L).A skin biopsy specimen from a chest papule was stained with hematoxylin-eosin (Fig 3). Special stains were also performed (Fig 4).What is your diagnosi?

DIAGNOSIS:  Popular mucinosis (lichen myxedematosus)

HISTOPATHOLOGIC FINDINGS  A biopsy specimen of a papule was obtained. The epidermis

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