Acral papular mucinosis: a new case of this rare entity

Abstract Acral persistent papular mucinosis (APPM) is a rare subtype of localized lichen myxedematosus. It consists of small papules localized exclusively on the back of the hands, wrists and extensor aspects of distal forearms with no other clinical or laboratory manifestations. The lesions tend to persist and may increase slowly in number. Histologically, hematoxylin-eosin and Alcian blue staining demonstrate mucin accumulation in the upper reticular dermis with separation of collagen fibers as a result of hyaluronic acid deposition. Treatment is rarely necessary due to the absence of symptoms. We present a 27-year-old healthy woman with asymptomatic papules on her upper extremities, which adequately meet clinical and pathological criteria of acral papular mucinosis.

Mononucleosis infecciosa / Infectious mononucleosis

La mononucleosis infecciosa debe sospecharse en pacientes que cursan un cuadro pseudogripal que evoluciona a una faringoamigdalitis inespecífica y aparición de lesiones cutáneas, que frecuentemente se confunde con una infección bacteriana. Su expresión en la piel da lugar a dos tipos de exantemas. El primero, de aparición temprana, polimorfo y que resuelve en pocos días y otro, llamado sinérgico, relacionado con la administración de antibióticos. Presentamos el caso de una paciente con mononucleosis infecciosa que desarrolló un exantema de tipo sinérgico.

Infectious mononucleosis should be suspected in patients who have flu-like symptoms which progress to nonspecific pharyngitis and skin lesions. It is usually confused with a bacterial infection. Expression in the skin gives rise to two types of exanthemas. The first one, early-onset, polymorphous and early-resolution. The other one, also called synergic, related to antibiotics. We report a case of a patient with an infectious mononucleosis and a synergic exanthema.