Cutaneous Focal Mucinosis With Spontaneous Healing
Journal of Cutaneous Pathology 10(5): Oct 1983; 334-339
View Original Source →Abstract
A case of extensive cutaneous focal mucinosis is described. The patient had insulin-dependent diabetes mellitus with complications in the peripheral circulation. No thyroid abnormality was found. The diagnosis was confirmed by typical clinical appearance, by light and electron microscopy. Shortly after the biopsies were taken, clinical healing became evident, a phenomenon which was clearly seen at the ultramicroscopic level. On the basis of the present case, supported by sparse evidence from the literature, it seems probable that cutaneous focal mucinosis does not present a real neoplasm, but a reactive condition with a possibility of spontaneous healing.
Case Details
Personal Characteristics
A finnish male patient, 57 years old, suffering from complicated diabetes mellitus
Clinical Characteristics
Developed asymptomatic, vesicle-like firm nodules on a palm-wide area in his right leg. Between the smooth nodules there were several indurated plaques of dark hue. His left leg had been previously amputated because of diabetic gangrene.
Remission Characteristics
During follow up we noted that the residual lesions began to involute, the skin became smooth, no further cystic lesions developed, and 2 months after the first biopsy the skin was normal. After 11 months the leg is still free of recurrences.
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Cutaneous focal mucinosis was confirmed histopathologically. Further biopsies were taken for direct immunofluorescence and electron microscopy. Due both to circulatory insufficiency in the leg and the large diameter of the lesion, it was not excised.
Additional Notes
Laboratory investigation did not reveal any abnormality in blood count, serum electrophoresis, immunoelectrophoresis, or the quantitation of immunoglobulins. Thyroid function tests (S-T4, S-T3U) were normal, no thyroid antibodies could be detected in the serum. In spite of several attempts to stabilize it, the blood glucose level has been unstable, between 10-20 mmoles/l.