FOLLICULAR MUCINOSIS IN A PATIENT WITH PARAPSORIASIS

Abstract

We present the case of a young patient, without comorbidities, who developed an erythematous-squamous, disseminated, discrete itchy rash, associated with scarring alopecia at the level of the scalp and the external third of the eyebrows, in 3-year evolution, in which two skin biopsies showed: subacute spongiotic dermatitis and psoriasiform dermatitis. As new lesions continued to appear despite treatment with phototherapy, systemic, local corticosteroids, it was decided to perform another skin biopsy: loose areas, granular appearance that color blue with Alcian Blue staining, thus supporting the diagnosis of follicular mucinosis. The treatment consisted of Acitretin 30 mg / day, with favorable evolution. Follicular mucinosis is a rare inflammatory disease, characterized by mucin deposits located in the follicular epithelium and sebaceous glands. There are two clinical forms: a primary, benign, limited to the skin, and a secondary form, commonly associated with cutaneous T-cell lymphoma. The evolution of both forms of follicular mucinosis is a chronic one, and the correct therapeutic attitude consists primarily in the periodic surveillance of the patient, with possible repeat biopsy, to exclude the form associated with a mycosis fungoides. The management of such patients is extremely difficult, as a number of conditions must be evaluated, such as: screening for collagenosis, diabetes, inflammatory bowel disease, evaluation of thyroid function, tumor markers.