Wang Peng, Yang Hanjun, Ran Yuping
Department of Dermatovenereology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Wang Hou District, Chengdu, People's Republic of China, 610041.
Arch Dermatol. 2011 May;147(5):599-602. doi: 10.1001/archdermatol.2011.110.
Papular mucinosis is an idiopathic cutaneous mucinosis. It includes 3 clinicopathologic subsets according to the recent Rongioletti classification: a generalized papular form, a localized form, and atypical forms. The localized form is subdivided into 5 subtypes. The atypical form does not meet the criteria for either the generalized papular form or the localized forms and includes localized forms with monoclonal gammopathy and/or systemic symptoms.
We describe a 37-year-old man who had multiple small, waxy papular lesions on the neck for 4 years. One year after the lesions first appeared, he developed IgA nephropathy. No paraproteinemia or thyroid dysfunction was observed. Histologic examination of the skin lesions showed mucin deposits in the upper dermis. Alcian blue-positive mucin was also found in the renal interstitium and around some vessels and capillary loops. A diagnosis of localized papular mucinosis with IgA nephropathy (atypical form) was made after the biopsy.
The patient showed an unusual manifestation of localized papular mucinosis with the lesions confined to the neck and IgA nephropathy. Alcian blue staining is a useful way to determine kidney involvement of papular mucinosis.
丘疹性黏蛋白病是一种特发性皮肤黏蛋白病。根据最近的荣焦莱蒂分类,它包括3种临床病理亚型:泛发性丘疹型、局限性型和非典型型。局限性型又细分为5个亚型。非典型型不符合泛发性丘疹型或局限性型的标准,包括伴有单克隆丙种球蛋白病和/或全身症状的局限性型。
我们描述了一名37岁男性,其颈部出现多个小的蜡样丘疹性病变已有4年。病变首次出现1年后,他患上了IgA肾病。未观察到副蛋白血症或甲状腺功能障碍。皮肤病变的组织学检查显示真皮上层有黏蛋白沉积。在肾间质以及一些血管和毛细血管袢周围也发现了阿尔辛蓝阳性黏蛋白。活检后诊断为伴有IgA肾病的局限性丘疹性黏蛋白病(非典型型)。
该患者表现出局限性丘疹性黏蛋白病的不寻常表现,病变局限于颈部并伴有IgA肾病。阿尔辛蓝染色是确定丘疹性黏蛋白病肾脏受累情况的一种有用方法。