Published online May 6, 2023. doi: 10.12998/wjcc.v11.i13.3086
Peer-review started: December 29, 2022
First decision: March 10, 2023
Revised: March 22, 2023
Accepted: March 31, 2023
Article in press: March 31, 2023
Published online: May 6, 2023
Processing time: 117 Days and 5.8 Hours
Acral persistent papular mucinosis (APPM) is a rare idiopathic subtype of localized lichen myxedematosus. To date, there have been 40 APPM cases reported worldwide; however, only 7 cases have been reported in the Korean literature.
A 70-year-old man was referred to our hospital with a solitary pinkish nodule on the dorsum of his right hand. Despite the absence of symptoms, the patient wanted to know the exact diagnosis; thus, a biopsy was performed. Histopathological examination of a biopsy specimen obtained from the nodule on the dorsum of his hand revealed orthokeratotic hyperkeratosis with patchy parakeratosis, prominent hypergranulosis, and diffuse dissecting mucinous deposition between collagen bundles, along with some bland-looking spindle cells throughout the dermis. The nodule was histologically diagnosed as an APPM, and an intralesional triamcinolone injection (2.5 mg/mL) was started every 2 wk. After three sessions of treatment, the patient showed marked improvements.
To the best of our knowledge, this is the first case of a Korean APPM presenting as a solitary nodule that showed a marked response to triamcinolone intralesional injection. Since it is a rare disease, we report this case to contribute to future research on the pathogenesis and treatment of APPM.
Core Tip: Acral persistent papular mucinosis (APPM) is a rare idiopathic subtype of localized lichen myxedematosus. To date, 40 cases have been reported worldwide; however, only seven cases have been reported in the Korean literature. This article reports on a rare case of solitary APPM, which was histologically diagnosed in a 70-year-old Korean man with a pinkish nodule on the dorsum of his hand. The patient showed marked improvement after three sessions of intralesional triamcinolone injection. This is the first reported case of a Korean APPM presenting as a solitary nodule and emphasizes the importance of continued research into the pathogenesis and treatment of this rare disease.