Tenea Daniela, Campaini Cinzia
Department of Dermatology, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa.
Department of Anatomical Pathology (National Health Laboratory Services), Dr. George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa.
Case Rep Dermatol. 2023 Jul 17;15(1):117-125. doi: 10.1159/000531464. eCollection 2023 Jan-Dec.
Reticular erythematous mucinosis is a rare and persistent form of primary idiopathic mucinosis, often referred to as plaque-like cutaneous mucinosis or midline mucinosis. It presents with reticulate patches or erythematous plaques with predilection for the anterior and posterior trunk. Affected patients are frequently asymptomatic. Pruritus or burning sensations were reported after exposure to the sun. The aetiology remains obscure; its pathogenesis is poorly understood, particularly in immunocompromised patients such as HIV-infected patients. The disease associations are not uniformly documented. Antimalarial agents significantly improve and shorten the course of the disease. We report a case of a 31-year-old African woman with underlying HIV infection who displayed the classical clinical and histological features of reticular erythematous mucinosis. This condition is rare among the HIV-infected patients, particularly in those of African descent, in whom lichen myxoedematosus/scleromyxoedema variants and acral persistent papular mucinoses were most frequently reported. The higher incidence of photosensitivity in HIV-infected individuals including the patients with skin of colour may play a potential role in reticular erythematous mucinosis. Its relationship with lupus erythematosus and photosensitivity in the context of HIV infection is discussed. To the best of our knowledge, this is the first reported case of reticular erythematous mucinosis in an African HIV-infected patient. This case highlights the need for diagnostic awareness in cases presenting with erythematous plaques and patches in a net-like pattern developing on the midline and sun-exposed areas of the trunk.
网状红斑性黏蛋白病是原发性特发性黏蛋白病的一种罕见且持续存在的形式，常被称为斑块状皮肤黏蛋白病或中线黏蛋白病。其表现为网状斑块或红斑性斑块，好发于躯干前后部。受累患者通常无症状。据报道，暴露于阳光下后会出现瘙痒或烧灼感。病因仍不明确；其发病机制了解甚少，尤其是在免疫功能低下的患者中，如感染HIV的患者。疾病关联情况尚无统一记录。抗疟药可显著改善病情并缩短病程。我们报告一例31岁的非洲女性，患有潜在的HIV感染，表现出网状红斑性黏蛋白病的典型临床和组织学特征。这种情况在感染HIV的患者中很少见，尤其是在非洲裔患者中，他们最常报告的是黏液水肿性苔藓/硬化性黏液水肿变体和肢端持续性丘疹性黏蛋白病。包括有色人种皮肤患者在内的HIV感染者中较高的光敏性发生率可能在网状红斑性黏蛋白病中起潜在作用。本文讨论了其在HIV感染背景下与红斑狼疮和光敏性的关系。据我们所知，这是首例报道的非洲HIV感染患者发生网状红斑性黏蛋白病的病例。该病例强调了对于在躯干中线和阳光暴露部位出现网状红斑性斑块的病例提高诊断意识的必要性。
