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LETTER TO EDITOR
Year : 2000  |  Volume : 66  |  Issue : 2  |  Page : 109

Morphoea with mucin deposits masquerading as scleromyxoedema




Correspondence Address:
Apra Sood


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Source of Support: None, Conflict of Interest: None


PMID: 20877049

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How to cite this article:
Sood A, Sharma S. Morphoea with mucin deposits masquerading as scleromyxoedema. Indian J Dermatol Venereol Leprol 2000;66:109

How to cite this URL:
Sood A, Sharma S. Morphoea with mucin deposits masquerading as scleromyxoedema. Indian J Dermatol Venereol Leprol [serial online] 2000 [cited 2019 Jun 24];66:109. Available from: http://www.ijdvl.com/text.asp?2000/66/2/109/4891


To the editor:

We recently saw a patient with morphoea whose histopathological examination showed abundant mucin deposits. This led us to investigate the patient on the lines of scleromyxoedema. However, mucin deposits in morphoea and scleroderma are well known, though rarely reported.

A 44-year-old man presented with a gradually progressive plaque on the left side of the chest since 9 months. Except for mild tightening of the skin there was no other cutaneous or systemic symptom. Examination revealed a 15X10 cm, erythematous to brown coloured shiny plaque involving the lower part of the chest and the epigastric area on the left side. The skin and underlying subcutaneous tissue were indurated. The biopsy showed homogenization and thickening of the collagen bundles in the middle and lower dermis consistent with morphoea. In addition there were multiple focal mucinous deposits in middle and lower dermis. The hemogram, including peripheral smear and hepatic and renal function tests were normal. Anti-nuclear antibodies were negative. The 24-hour urinary proteins were within the normal range and urine was negative for Bence-Jones proteins. Total serum proteins were normal. There was no M-band on serum electrophoresis. The bone marrow was cellular with normal hemopoietic cells of all series. The chest radiograph showed evidence of healed pulmonary tuberculosis and the radiological survey was normal. In view of the above investigation reports a diagnosis of morphoea with mucin deposits

was made

There are very few reports of mucin deposition in scleroderma and morphoea and it is not mentioned in the major textbooks of dermatopathology. [1],[2] This was first noticed by Braun-Falco [3] and subsequently reported in patients of morphoea and scleroderma. Rongioletti et al [4] found mucin deposits in all of the biopsy specimens examined in twenty patients of scleroderma. Mucin deposits vary from abundant to slight and are seen best with alcian blue at pH 2.5. [4] The deposits are mainly in the deeper dermis and interlobular septa and detection requires a deeper biopsy. The amount of the mucin is not related to the duration of the disease. Although its significance is not clear, dermatologists and pathologists should be aware of this finding in morphoea and scleroderma.







 
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1.Lever WF, Schaumburg-Lever G. Histopathology of the Skin, ed 7th. Philadelphia, Lippincott, 1990. pp 511-516.  Back to cited text no. 1    
2.Mehergan AH, Hashimoto K. Pinkus Guide to Dermatohistopathology, ed 5th. Englewood Cliffs, Prentice-Hall International, 1991, pp 351-353.  Back to cited text no. 2    
3.Braun-Falco 0. Uber das Verhalten der interfibrillaren Grundsubstanz bei Sklerodemie. Dennatol Wochenschr 1957; 136:1085-1089.  Back to cited text no. 3    
4.Rongioletti F, Gambini C, Micalizzi et al. Mucin Deposits in Morphoea and Systemic Scleroderma. Dermatology 1994 ; 189 157-158.  Back to cited text no. 4    




 

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