Sunday, August 04, 2013

Follicular Mucinosis?

Abstract: 80 yo man with intensely pruritic papules face and neck for 2 months

HPI:  This 80 yo man has a 2 month history of 2 – 3 mm erythematous papules, mostly on face and neck. These are few in number.  A trial cobetasol ointment was without relief.  His medications are: amlodipine, HCTZ, metroprolol, Vytorin (ezetimibe and eimvastatin), Pantoprazole.  He is in good general health.

ClinicalPhotos: These show how subtle the lesions are.

Because of symptoms a Biopsy was done.
Histopath shows: focal erosion and ulceration and ectatic blood vessels.  There is a moderate to dense superficial and deep perivascular perifollicular lymphohistiocytic infiltrate with numerous eosinophils, marked mucin deposition and conspicuous disruption of the follicular epitheliumThe pathologic diagnosis includes, “infectious etiology,” eosinophilic folliculitis, and follicular mucinosis.

Diagnosis:  Acneiform Follicular Mucinosis might be the best fit.


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