Self-healing juvenile cutaneous mucinosis: Clinical and histopathologic findings of 9 patients: The relevance of long-term follow-up

J Am Acad Dermatol. 2018 Jun;78(6):1164-1170. doi: 10.1016/j.jaad.2017.10.023. Epub 2017 Oct 21.

Abstract

Background: Self-healing juvenile cutaneous mucinosis (SHJCM) is a rare disorder, and its pathogenesis and long-term prognosis are unknown.

Objective: To elucidate the clinical and histopathologic characteristics, pathogenesis, and outcome in patients with SHJCM.

Methods: Retrospective study of 9 patients with SHCJM. To complement initial findings, data collection forms were sent to the referring physicians.

Results: All patients had an acute onset of firm nodules. Of the 9 patients, 6 presented initially with waxy papules on the dorsum of the hands; 5 suffered from periorbital edema, and 6 had a febrile prodrome. Histopathologic assessment of the papules revealed dermal mucin deposition, whereas the nodules showed proliferative fasciitis-like features or nonspecific chronic lobular panniculitis. Laboratory studies elicited evidence of active viral infection in 2 patients (human herpes virus 6 and rotavirus). Seven cases had spontaneous resolution within 6 months, and 2 patients with incomplete resolution showed subsequent transition to fibroblastic rheumatism and an autoinflammatory rheumatologic disease, respectively.

Limitations: This was a retrospective study with incomplete data from referring physicians.

Conclusions: Although spontaneous complete regression is expected, patients with SHJCM need long-term follow-up because of the possible development of dematorheumatolgic conditions. The pathogenetic role of microbial agents deserves further investigation.

Keywords: child; cutaneous mucinosis of infancy; fasciitis; lichen myxoedematosus; mucinosis; nodules; papular mucinosis; self-healing juvenile cutaneous mucinosis.

Publication types

  • Multicenter Study

MeSH terms

  • Age Factors
  • Biopsy, Needle
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Incidence
  • Infant
  • Male
  • Monitoring, Physiologic / methods
  • Mucinoses / epidemiology
  • Mucinoses / pathology*
  • Mucinoses / physiopathology*
  • Remission, Spontaneous*
  • Retrospective Studies
  • Risk Assessment
  • Sampling Studies
  • Severity of Illness Index
  • Sex Factors
  • Skin Diseases, Papulosquamous / epidemiology
  • Skin Diseases, Papulosquamous / pathology*
  • Skin Diseases, Papulosquamous / physiopathology*
  • Time Factors