FOLLICULAR MUCINOSIS IN A PATIENT WITH PARAPSORIASIS

Florica Sandru; Mihai Cristian Dumitrascu; Adelina Popa; Carmen Cristina Draghici; Ana Maria Alexandra Stanescu; Raluca Gabriela Miulescu

doi:10.33695/rjcr.v2i2.31

Florica Sandru Elias Emergency University Hospital, Bucharest, UMF ” Carol Davila” Bucharest
Mihai Cristian Dumitrascu Emergency University Hospital Bucharest, UMF ”Carol Davila” Bucharest
Adelina Popa Elias Emergency University Hospital, Bucharest
Carmen Cristina Draghici Elias Emergency University Hospital, Bucharest
Ana Maria Alexandra Stanescu UMF ”Carol Davila”, Bucharest, Romania
Raluca Gabriela Miulescu Elias Emergency University Hospital, Bucharest

DOI: https://doi.org/10.33695/rjcr.v2i2.31

Keywords: follicular mucinosis, primary follicular mucinosis, mycosis fungoides, follicular mucinosis associated disorders, alopecia mucinosa, follicular mucinosis treatment

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.

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