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Alopecia Mucinosa Clinical Presentation

  • Author: Gervaise L Gerstner, MD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Oct 08, 2015
 

History

The presenting sign of alopecia mucinosa is hair loss in hair-bearing areas. Skin eruptions present as pruritic, pink–to–yellow-white, follicular papules and plaques. Lesions may be isolated or multiple. Mycosis fungoides is recognized at the time of diagnosis in approximately 15-30% of patients with alopecia mucinosa.

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Physical

The clinical manifestations of alopecia mucinosa are grouped follicular papules and alopecia. Nodules, plaques, and patches of follicular papules may exist. Occasionally, mucinous material can be expressed from active lesions, and erythema and scaling are usually present. The face and the scalp are the most common sites of involvement.

The alopecia that develops on hair-bearing skin is of the nonscarring type (see the image below).

Courtesy of San Antonio Uniformed Services Health Courtesy of San Antonio Uniformed Services Health Education Consortium (SAUSHEC) teaching files.

Usually, the alopecia is reversible unless follicular destruction has occurred due to excess mucin in the outer root sheath and sebaceous glands. In patients with permanent alopecia, the whole follicle degenerates, and the cystic cavity becomes blocked with keratinous debris. When the plugs persist, they are obvious features on healed, hairless patches of alopecia mucinosa.

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Causes

Alopecia mucinosa represents various stages of follicular damage leading to hair loss. The reactive process is of unknown etiology. The role of circulating immune complexes and cell-mediated immunity has been considered.

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Contributor Information and Disclosures
Author

Gervaise L Gerstner, MD Assistant Clinical Professor, Department of Dermatology, Mount Sinai Hospital; Partner, Park Avenue Skin Care

Disclosure: Nothing to disclose.

Coauthor(s)

Mark G Lebwohl, MD Chairman, Department of Dermatology, Mount Sinai School of Medicine

Mark G Lebwohl, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Received none from Amgen for consultant & investigator; Received none from Novartis for consultant & investigator; Received none from Pfizer for consultant & investigator; Received none from Celgene Corporation for consultant & investigator; Received none from Clinuvel for consultant & investigator; Received none from Eli Lilly & Co. for consultant & investigator; Received none from Janssen Ortho Biotech for consultant & investigator; Received none from LEO Pharmaceuticals for consultant & inves.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD Associate Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

Günter Burg, MD Professor and Chairman Emeritus, Department of Dermatology, University of Zürich School of Medicine; Delegate of The Foundation for Modern Teaching and Learning in Medicine Faculty of Medicine, University of Zürich, Switzerland

Günter Burg, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, International Society for Dermatologic Surgery, North American Clinical Dermatologic Society, and Pacific Dermatologic Association

Disclosure: Nothing to disclose.

References
  1. Pinkus H. Centennial Paper. Alopecia mucinosa. Inflammatory plaques with alopecia characterized by root-sheath mucinosis. By Hermann Pinkus, M.D., Arch Dermatol 1957. Arch Dermatol. 1983 Aug. 119(8):690-7. [Medline].

  2. Dalle S, Marrou K, Balme B, Thomas L. Neonatal follicular mucinosis. Br J Dermatol. 2007 Sep. 157(3):609-10. [Medline].

  3. Buchner SA, Meier M, Rufli T. Follicular mucinosis associated with mycosis fungoides. Dermatologica. 1991. 183(1):66-7. [Medline].

  4. Clark-Loeser L, Latkowski JA. Follicular mucinosis associated with mycosis fungoides. Dermatol Online J. 2004 Nov 30. 10(3):22. [Medline].

  5. Lacour JP, Castanet J, Perrin C, Ortonne JP. Follicular mycosis fungoides. A clinical and histologic variant of cutaneous T-cell lymphoma: report of two cases. J Am Acad Dermatol. 1993 Aug. 29(2 Pt 2):330-4. [Medline].

  6. Bi MY, Curry JL, Christiano AM, Hordinsky MK, Norris DA, Price VH, et al. The spectrum of hair loss in patients with mycosis fungoides and Sézary syndrome. J Am Acad Dermatol. 2011 Jan. 64(1):53-63. [Medline].

  7. Dalle S, Balme B, Berger F, Hayette S, Thomas L. Mycosis fungoides-associated follicular mucinosis under adalimumab. Br J Dermatol. 2005 Jul. 153(1):207-8. [Medline].

  8. Scheinfeld N. Imatinib mesylate and dermatology part 2: a review of the cutaneous side effects of imatinib mesylate. J Drugs Dermatol. 2006 Mar. 5(3):228-31. [Medline].

  9. Roth DE, Owen LG, Hodge SJ, Callen JP. Follicular mucinosis associated with pregnancy. Int J Dermatol. 1992 Jun. 31(6):441-2. [Medline].

  10. Lockshin BN, Khachemoune A, Cohen C. Follicular mucinosis in a 4-year-old boy. Int J Dermatol. 2004 Dec. 43(12):950-2. [Medline].

  11. Nickoloff BJ, Wood C. Benign idiopathic versus mycosis fungoides-associated follicular mucinosis. Pediatr Dermatol. 1985 Mar. 2(3):201-6. [Medline].

  12. Gibson LE, Muller SA, Leiferman KM, Peters MS. Follicular mucinosis: clinical and histopathologic study. J Am Acad Dermatol. 1989 Mar. 20(3):441-6. [Medline].

  13. Fernandez-Guarino M, Harto Castano A, Carrillo R, Jaen P. Primary follicular mucinosis: excellent response to treatment with photodynamic therapy. J Eur Acad Dermatol Venereol. 2008 Mar. 22(3):393-4. [Medline].

  14. Meissner K, Weyer U, Kowalzick L, Altenhoff J. Successful treatment of primary progressive follicular mucinosis with interferons. J Am Acad Dermatol. 1991 May. 24(5 Pt 2):848-50. [Medline].

 
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Courtesy of Dirk M. Elston, MD.
Courtesy of Dirk M. Elston, MD.
Courtesy of San Antonio Uniformed Services Health Education Consortium (SAUSHEC) teaching files.
 
 
 
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