ABSTRACT
Discrete papular lichen myxedematosus (DPLM), asubset of localized lichen myxedematosus, is a rarecutaneous mucinosis of unknown etiology. We reporta case of a 57-year-old woman with palmoplantarpsoriasis who developed DPLM 8 weeks after addingustekinumab to a long-term course of methotrexate.The patient had previously failed 2 prior tumor necrosisfactor (TNF) inhibitors, adalimumab and etanercept.This case demonstrates an association between TNFinhibitor and ustekinumab use in a psoriasis patientand localized lichen myxedematosus for the secondtime in the literature. The presented case is of interestbecause of the rare diagnosis of DPLM, especially inassociation with the start of the anti-IL 12/23 agentustekinumab. The appearance of DPLM in this settingsuggests a possible etiology for the disease.
Subject(s)
Dermatologic Agents/therapeutic use , Facial Dermatoses/diagnosis , Psoriasis/drug therapy , Scleromyxedema/diagnosis , Ustekinumab/therapeutic use , Facial Dermatoses/pathology , Facial Dermatoses/surgery , Female , Humans , Middle Aged , Scleromyxedema/pathology , Scleromyxedema/surgeryABSTRACT
BACKGROUND AND OBJECTIVES: Acral persistent papular mucinosis (APPM) is a rare condition with persistent flesh colored papules on the hands and extensor wrists. The authors aim to present a novel treatment option for this condition. PATIENTS AND METHODS: A female with APPM was treated using a 2940 nm Erbium-YAG laser with a 1 mm spotsize defocused to 2-3 mm with settings of 200-300 mJ until the lesion was flush with the surrounding skin. RESULTS: Healing of the wounds with resolution of the individually treated papules. CONCLUSIONS: Erbium-YAG lasers should be considered a treatment option for APPM.
