Obesity-associated lymphedematous mucinosis and stasis mucinosis |
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| Institution: | 1. Department of Family Medicine, University of Ottawa School of Medicine, Ottawa, Ontario, Canada;2. Foundation Doctor, Royal Surrey County Hospital, Egertin Rd, Guildford, United Kingdom SE1 7EH;3. Editor (Ancient) of The Numismatic Chronicle, c/o Department of Coins and Medals, British Museum, London, UK WC1B 3DG;4. Consultant Dermatologist & Research Lead: Norfolk & Norwich University Hospital, Norfolk, UK;1. Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA;2. Department of Dermatology, Tulane University School of Medicine, New Orleans, Louisiana, USA;3. Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA;1. Department of Internal Medicine, Griffin Hospital, Derby, Connecticut, USA;2. Iterum Therapeutics, Old Saybrook, Connecticut, USA;1. Private Practice, Pembroke Pines, Florida, USA;2. Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA |
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| Abstract: | Cutaneous dermal mucinoses are a group of conditions characterized by abnormal deposition of mucin (hyaluronic acid and sulfated glycosaminoglycans) in the dermis. They can be classified either as localized or generalized forms and occur primarily or secondarily to systemic disorders. Obesity-associated lymphedematous mucinosis and pretibial stasis mucinosis are uncommon and relatively newly recognized disorders occurring in obese patients or in patients with venous insufficiency. Clinically, patients present with papules and nodules progressing to plaques and arising in an erythematous and edematous basis on the legs, especially the shins. Histopathologic examination indicates mucin deposition in the superficial portion of the dermis, angioplasia with an increase in small blood and/or lymphatic vessels, vertically running vessels, slight fibrosis, and no inflammation. Laboratory workup and histopathologic testing are helpful in differentiating these entities from pretibial myxedema (thyroid dermopathy), which represents the main differential diagnosis. Obesity-associated lymphedematous mucinosis and stasis mucinosis are not different entities but belong to a spectrum of mucinoses secondary to an increased body mass index, chronic lymphedema, and/or chronic venous insufficiency. |
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