Lichen myxedematosus. An unusual case with rapid progression and possible internal involvement.

Lichen myxedematosus (papular mucinosis) is a slowly progressive mucinous disorder that is thought by many to have no internal organ involvement. We report a case of lichen myxedematosus (lichenoid plaque type) that is remarkable for the sudden and rapid nature of the infiltrative process with both cutaneous and possibly systemic manifestations. The cutaneous abnormalities were successfully treated with cyclophosphamide and intralesional steroids. The fact that our patient's systemic signs and symptoms also responded to therapy supports the concept of internal involvement in lichen myxedematosus.