A rare case of acral persistent papular mucinosis

Acral persistent papular mucinosis: A case report and summary of 24 Japanese cases

Acral persistent papular mucinosis is a rare subtype of localized lichen myxedematosus. We report a case of a 41-year-old woman with acral persistent papular mucinosis. She had a 5-year history of multiple, scattered, whitish papules, on the back of both hands, of 2-5 mm in diameter. Histopathological examination revealed a focal, fairly circumscribed area with sparse collagen fibers in the upper and middle dermis. The circumscribed area was positively stained with Alcian blue. The papules were clinically and histologically diagnosed as acral persistent papular mucinosis. We also summarized 24 Japanese acral persistent papular mucinosis cases, including ours. Although acral persistent papular mucinosis occurs predominantly in women according to overseas reports, the male : female ratio is 5:7 in Japan. It has been reported that tranilast (N-[3,4-dimethoxycinnamoyl]-anthranilic acid) was effective in two Japanese cases. In our case, the patient had been treated with tranilast for 2 months without improvement. Further studies are required to confirm the efficacy of tranilast for acral persistent papular mucinosis.

Cutaneous Manifestations in Pancreatic Diseases-A Review

Pancreatic pathology, comprising acute and chronic pancreatitis, autoimmune pancreatitis and pancreatic neoplasms, primarily presents with gastrointestinal symptoms and signs; however, it is well recognized that it can also associate a wide range of extra-digestive features. Among these systemic manifestations, cutaneous involvement plays an important role both as a diagnostic clue for the pancreatic disease itself and serving as a prognostic factor for the severity of the condition. Recognition of these cutaneous signs is, however, far from being satisfactory, all the more as some of them are relatively rare. In the current review, we discuss skin involvement in pancreatic diseases, referring to pancreatic panniculitis, cutaneous hemorrhagic manifestations, skin metastasis, acanthosis nigricans, livedo reticularis, necrolytic migratory erythema and cutaneous fistula. We highlight the clinical characteristics, treatment and prognostic value of these lesions. Better awareness among medical specialties other than dermatology is needed for detection of the skin clues associated with pancreatic pathology.