Follicular mucinosis is a term that encompasses three related entities. Alopecia mucinosa, Urticaria-like follicular mucinosis, and cutaneous lymphoma related. On hair-bearing skin (e.g. scalp), overlying alopecia is notable, hence the term “ alopecia mucinosa” (see Figure 5). Plaques are often composed of densely. Alopecia mucinosa is a skin disorder that generally presents, but not exclusively, as erythematous plaques or flat patches without hair primarily on the scalp.
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Follicular Mucinosis (Alopecia Mucinosa)
Therapy should be a,opecia to the individual patient, with consideration given to the extent of involvement lesion location, size, number. The upper and mid dermis had alopecix moderately dense perivascular lymphocytic infiltrate with few eosinophils. A clinical diagnosis of leprosy was considered and she was asked to apply a moisturizing cream and kept under observation as a biopsy was refused.
The authors suggest that in regions endemic for leprosy, such as India, single lesion Alopecia mucinosa on the face in children and young adults should be given antileprosy treatment. Dapsone mg orally, daily; response within 3 months; taper not defined, recurrence may occur upon discontinuation. Given the association with CTCL, as well as much rarer associations with other hematologic malignancies e.
It is common practice that in regions endemic for leprosy, such as India, children and young adults who present with single hypoesthetic lesions on the face are not biopsied but treated on clinical suspicion alone and because they respond to MDT would be labeled as leprosy. And are there other choices?
From Wikipedia, the free encyclopedia. J Am Acad Dermatol. Intralesional corticosteroids—triamcinolone acetonide, 2.
Follicular mucinosis as the only histological finding without granulomas has been recently described in children with suspected leprosy who had complete clearing of the lesions with standard multi drug therapy MDT for leprosy. Careful perusal of literature reveals that only two papers[ 89 ] have reported response to dapsone. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.
Alopecia mucinosa, also known as follicular mucinosis, describes the appearance alopwcia mucin around hair follicles as seen under the microscope. Follicular mucinosis as a finding has been recorded as an additional histological marker in type 1 reactional state in borderline leprosy.
What is the Cause mcinosa the Disease? Guitart, J, Magro, C. Self-skin examination New smartphone apps to check your skin Learn more Sponsored content. Treatment based on several case reports. If lesional morphology should change considerably, skin biopsies should be repeated.
He had been advised topical Tretinoin and Deoximetasone creams, which he used without any improvement over 3 months.
The presence of intrafollicular mucin can be confirmed with colloidal iron tissue stains. The lesions of Alopecia mucinosa tend to persist for months or years and may show spontaneous clearing, however, in general the therapy for muccinosa mucinosa remains nonspecific as no single agent has been shown to consistently improve this condition.
All our cases presented with single lesions which demonstrated hypoesthesia.
Follicular Mucinosis (Alopecia Mucinosa)
The presence of lesional skin T-cell clonality in FM does not portend a poorer prognosis. Ingrown nail Anonychia ungrouped: We have not been able to find any reported case of Alopecia mucinosa treated with dapsone alone. Pseudopelade of Brocq Central centrifugal cicatricial alopecia Pressure alopecia Traumatic alopecia Tumor alopecia Hot comb alopecia Perifolliculitis capitis abscedens et suffodiens Graham-Little syndrome Folliculitis decalvans ungrouped: The etiology is not known.
Cell mediated immune mechanisms play a role in the pathogenesis aloprcia follicular mucinosis and T lymphocytes that infiltrate follicular epithelium may lead to destructive changes in the follicular keratinocytes to produce mucin.
Alopecia mucinosa | DermNet NZ
Clonal FM may regress completely. Open in a separate window.
Case 3 at presentation with erythematous plaque on left forehead. Received May; Accepted Aug. It has also been rarely reported in patients with neoplastic diseases, most commonly hematologic-based malignancies.
Abstract Three cases with single lesion of Alopecia mucinosa follicular mucinosis were treated with antileprosy treatment and showed rapid and complete resolution of the lesions with mucinosaa recurrence on extended follow-up. What is known is that mucinous material deposits and accumulates in hair follicles and sebaceous glands to create an inflammatory condition that subsequently breaks down the ability of the affected follicles to produce hair.
Mucosal surfaces, genitalia, and acral mucjnosa and soles areas are usually spared.
It may be due to dysfunctional T cells inducing mucin production by fibroblasts surrounding follicular epithelium, or due to excess production of mucin by follicular keratinocytes. Some treatments that have been tried with limited success include:. Few of the follicular infundibula showed features of follicular mucinosis with mild spongiosis, separation of the keratinocytes from one another, and clear spaces between the keratinocytes, which contained wisps of light blue-gray mucin.
Follicular mucinosis in suspected Leprosy. Intralesional corticosteroids or excision should be considered for refractory or localized lesions, where cosmetically acceptable. Alopecia mucinosa is diagnosed by its clinical appearance and supported by histopathological findings on biopsy:. Hydroxychloroquine mg orally, three times daily for 10 days, followed by mg orally, twice daily; response noted within 6 months, begin taper after lesions have cleared.
Mucin between follicular keratinocytes.
Alopecia Mucinosa Responding to Antileprosy Treatment: Are we Missing Something?
DermNet NZ does not provide an online consultation service. Indian J Dermatol Venereol Leprol. Of note, FM may resolve spontaneously.