Nodular lichen myxedematosus L98.5

Lichen myxoedematosus (LM) is a primary euthyroid mucinosis. In the updated classification of Rongioletti et al (Rongioletti F et al 2001; Rongioletti F 2006), the nodular type is a very rare variant of lichen myxoedematosus (<10 cases have been reported to date, including cases from Korea and Japan). In most cases of this variant, multiple firm, skin-colored or slightly reddish, painless nodules, nodules, and plaques are found on the limbs and trunk. A case with solitary nodular lichen myxoedematosus in a 74-year-old woman was reported in 2020 (Chae MH et al. 2020).

The age of onset of the cases published to date ranges from 4-74 years and thus affects all cohorts (Chae MH et al.2020; Zeng R et al.).

Histopathologically, collagen bundles are dispersed in the reticular to deep dermis. Epidermal changes are absent. With higher magnification, basophilic mucin deposits are found between the collagen fibers in the dermis, furthermore there is a clear proliferation of fibroblasts as well as sparse perivascular infiltrates of lymphocytes and plasma cells. Histochemically, the deposits are positive for Alcian blue.

A standard treatment for localized LM is not known due to the small number of cases. Local injections of triamcinolone acetonide seem to induce complete remissions (Ogita A et al. 2012).

1. Chae MH et al.(2020) Lichen myxedematosus presenting as a solitary nodule. Ann Dermatol 32:168-169.
2. Ferris GJ et al (2016) Mucin in the dermis: a case of tender tumors. Dermatol Online J 22:13030/qt4b50f4zf [
3. Harris JE et al (2004) Acral persistent papular mucinosis. J Am Acad Dermatol 51:982-988.
4. Ogita A et al (2012) Nodular-type lichen myxedematosus: a case report. Case Rep Dermatol 2:195-200.
5. Rongioletti F et al (2001) Updated classification of papular mucinosis, lichen myxedematosus, and scleromyxedema. J Am Acad Dermatol 44:273-281.
6. Rongioletti F (2006) Lichen myxedematosus (papular mucinosis): New concepts and perspectives for an old disease. Semin Cutan Med Surg 25:100-104.
7. Schneider BV et al (1991) Nodular cutaneous mucinosis. An unusual type of euthyreotic focal mucinosis. Dermatologica 183:73-76.
8. Zeng R et al (2014) Nodular lichen myxedematosus during childhood: a case report. Pediatr Dermatol 31:e160-3.
9. Suter L et al (1980) Atypical tuberous myxedema Jadassohn-Dössekker. Report of a case. Dermatologica 161:265-269.