ACRAL PERSISTENT PAPULAR MUCINOSIS
By Gary M. White, MD
Acral Persistent Papular Mucinosis (APPM) is a rare, benign condition where mucin is deposited in the skin, usually over the hands and wrists.
- Onset in adulthood.
- APPM is typically unassociated with a paraprotein, however, a patient with an IgA paraprotein has been reported.
- Workup: Measure SPEP, TSH and ANA because of the mucin in the dermis.
- Potent topical steroids have had some benefit.
- See also differential diagnosis for the mucinoses in scleromyxedema.
Small, flesh-colored, 3-4 mm dermal papules on the dorsal wrists and hands acquired by an adult is characteristic.
Potent topical steroids have had some benefit [Derm 1992;185;134].
A 53-year-old woman presented with multiple, asymptomatic 1~3 mm flesh-colored papules symmetrically located on both dorsum of hands and wrists, and on anterior chest. They first appeared 7~8 years ago and did not disappear. Ann Dermatol. 2016 Aug;28(4):517-519
Actas Dermo-Sifiliograficas .2006;97:522-4
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