Lichen myxedematosus
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Synopsis

- A discrete papular form
- Acral persistent papular mucinosis
- Cutaneous mucinosis of infancy
- A pure nodular form
Clinical features of LM vary based on the subtype. Discrete papular LM is characterized by the presence of 2- to 5-mm papules on the trunk and extremities. Unlike scleromyxedema, the face is typically spared and induration is not observed. In acral persistent papular mucinosis, patients present with papules on the dorsal hands and extensor forearms. In cutaneous mucinosis of infancy, patients present with papules or plaques on the neck, elbows, and trunk. Nodular LM is characterized by the development of multiple nodules on the trunk and extremities. In these localized variants, progression to scleromyxedema does not occur. While lesions tend to progress slowly, there is no systemic involvement.
In contrast to scleromyxedema, the criteria for the diagnosis of localized LM includes papular or nodular lesions or plaques, mucin deposition with or without fibroblast proliferation, absence of thyroid disease, and absence of monoclonal gammopathy.
Codes
ICD10CM:L98.5 – Mucinosis of the skin
SNOMEDCT:
111197009 – Lichen myxedematosus
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Differential Diagnosis & Pitfalls
- Papular granuloma annulare
- Lichen nitidus
- Molluscum contagiosum
- Lichen amyloidosis
- Colloid milium
- Eruptive collagenomas
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Last Reviewed:02/19/2019
Last Updated:02/19/2019
Last Updated:02/19/2019