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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Although clinically cases 1 and 2 and the four cases described earlier[ 10 ] were clinically diagnosed as leprosy, the biopsy did not show any granulomas or features diagnostic of leprosy, but instead showed in all cases follicular mucinosis.
Rajiv Joshi Department of Dermatology, P. Folliculitis Folliculitis nares perforans Tufted folliculitis Pseudofolliculitis barbae Hidradenitis Hidradenitis suppurativa Recurrent palmoplantar hidradenitis Neutrophilic eccrine hidradenitis. If lesional morphology should change considerably, skin biopsies should be repeated. Introduction What was known?
Expected results of diagnostic studies Skin biopsies are required for diagnosis. Hinduja Hospital, Mahim, Mumbai, India. Nil Conflict of Interest: DermNet NZ does not provide an online consultation service.
The presence of lesional skin T-cell clonality in FM does not portend a poorer prognosis. The patient completed all six doses of ROM, and has not had recurrence in the ensuing 1 year. In general, patients with idiopathic FM tend to be younger and have fewer and more localized lesions on the head or neck. Single lesion Alopecia mucinosa in children and young adults responds rapidly mkcinosa completely with antileprosy treatment.
Plaques are often composed of densely aggregated individual papules, many of which have a central spine. Indomethacin 25mg orally, twice daily; monitor for gastrointestinal adverse effects, electrolytes, and creatinine. Triangular alopecia Frontal fibrosing alopecia Marie Unna hereditary hypotrichosis.
Alopecia Mucinosa Responding to Antileprosy Treatment: Are we Missing Something?
Primary or idiopathic Alopecia mucinosa was first described in by Pinkus. Treatment based on several case reports.
Therefore it is too much of coincidence to consider that the response in all patients was due to natural remission, and it is most likely that it was the oral mkcinosa that brought about healing of the lesions.
For solitary or localized lesions, topical agents are first line because they are low risk, easy to administer, and low cost. All our cases presented with single lesions which demonstrated hypoesthesia.
Follicular Mucinosis (Alopecia Mucinosa)
Idiopathic follicular mucinosis on the trunk. Some papers[ 4aloprcia ] have shown good response of follicular mucinosis to minocycline, however, contrary results with very minimal or no improvement has also been reported in patients with Alopecia mucinosa who were treated with minocycline for more than 3 months. 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.
Histological features of the underlying disease are present in secondary alopecia mucinosa.
Dapsone has been reported to clear Follicular mucinosis and the presence of dapsone in the MDT may be the agent responsible for healing in cases 1 and 2. It is characterised by bald patches of skin in which hair follicles are prominent. The cause of alopecia mucinosa is unknown, but it aloepcia have something to do with mucjnosa immune complexes and cell-mediated immunity. Immunohistochemistry showed the infiltrating lymphocytes to be CD3 and CD4 positive.
Follicular mucinosis presenting as acute dermatitis with response to dapsone. While response to dapsone in the first six cases and minocycline in the last case is possible, the most consistent common factor in all cases seems to be antileprosy treatment.
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Avoid use in patients under age 8. Other conditions that may need to be considered in the differential diagnosis include:. Consider if patient is intolerant or unresponsive to first-line agents.
Suggested therapies are based on anecdotal reports or small case series. A year-old girl presented in Marchwith hair loss over left eyebrow and dry hypopigmented skin mucinoss adjacent forehead.