J Drugs Dermatol. 2020 Mar 1;19(3):320-322. doi: 10.36849/JDD.2020.4864.
Lichen myxedematosus (LM) is an idiopathic cutaneous mucinosis, commonly described as localized scleromyxedema. In contrast to scleromyxedema, there is typically no systemic involvement. Treatment options are limited and spontaneous resolution has been reported. We present the case of a 66-year-old Hispanic male referred by his primary care physician for evaluation of asymptomatic dark spots on his trunk and extremities present for about one-year. Physical exam revealed smooth, brown hyperpigmented papules coalescing into plaques on the trunk. Multiple well-demarcated oval dark brown plaques measuring 3 cm in size were located on the upper back, peri-umbilical area, bilateral lower extremities, and buttocks. A diagnosis of lichen myxedematosus was made based on histologic features observed in the dermis. There are 5 subtypes of LM: a discrete papular form, acral persistent papular mucinosis, self-healing papular mucinosis, papular mucinosis of infancy, and a pure nodular form. Occasional patients with LM have atypical features or features intermediate between scleromyxedema and localized LM. We present a case of atypical LM with mixed features of the different subtypes. Herein we will review the varied clinical presentations of LM and highlight the distinguishing features of scleromyxedema. J Drugs Dermatol. 2020;19(3): 320-322 doi:10.36849/JDD.2020.4864.
黏液性水肿性苔藓（LM）是一种特发性皮肤黏蛋白病，通常被描述为局限性硬肿性黏液水肿。与硬肿性黏液水肿不同，通常没有系统性受累。治疗选择有限，有自发缓解的报道。我们报告了一例 66 岁的西班牙裔男性病例，由他的初级保健医生转介，以评估他躯干和四肢上无症状的深色斑点，这些斑点存在了大约一年。体格检查显示躯干上光滑的棕色色素沉着性丘疹融合成斑块。背部、脐周区域、双侧下肢和臀部有多个界限清楚的椭圆形深棕色斑块，大小为 3 厘米。根据真皮中观察到的组织学特征，诊断为黏液性水肿性苔藓。LM 有 5 种亚型：离散性丘疹型、肢端持续性丘疹性黏蛋白病、自限性丘疹性黏蛋白病、婴儿期丘疹性黏蛋白病和单纯结节型。偶尔有 LM 患者具有不典型特征或介于硬肿性黏液水肿和局限性 LM 之间的特征。我们报告了一例不典型 LM，具有不同亚型的混合特征。本文回顾了 LM 的不同临床表现，并强调了硬肿性黏液水肿的鉴别特征。J 皮肤病药物治疗杂志。2020;19(3):320-322 .doi:10.36849/JDD.2020.4864.
