Discrete papular lichen myxedematosus

Discrete papular lichen myxedematosus is a skin condition caused by fibroblasts producing abnormally large amounts of mucopolysaccharides characterized by the occurrence of waxy, flesh-colored papules..

Signs and symptoms
Discrete papular lichen myxedematosus is typically identified by the presence of violaceous, flesh-colored, or reddish, waxy papules that range in size from 2 to 5 mm and that symmetrically affect the trunk and limbs.

Causes
This disease's etiology is still unknown.

Diagnosis
Histologically, a normal epidermis is covered by a diffuse or focal mucinous deposit and edema in the upper and mid dermis. Although there isn't any sclerosis or collagen deposition, fibroblast proliferation varies.

Treatment
Numerous therapies have been attempted, with varying degrees of success, such as dermabrasion, CO2 laser, intralesional injections of corticosteroids or hyaluronidase, oral retinoids, psoralen ultraviolet A, and pimecrolimus. Given its ability to inhibit both tumor necrosis factor-a and transforming growth factor-b, thus decreasing the synthesis of glycosaminoglycans by fibroblasts, topical tacrolimus 0.1% has recently been proposed as an effective substitute.