eMedicine Specialties > Dermatology > Diseases of the Dermis

Lichen Myxedematosus: Follow-up

Author: Elizabeth A Liotta, MD, Assistant Professor, Department of Dermatology, Uniformed Services University of the Health Sciences
Contributor Information and Disclosures

Updated: Jan 14, 2009

Follow-up

Further Outpatient Care

  • Patients should undergo periodic follow-up.
  • Patients should be referred to specialists for evaluation as needed for specific systemic complaints.

Prognosis

  • For lichen myxedematosus, the prognosis is a chronic course with little tendency for spontaneous resolution.
  • Scleromyxedema usually has a poorer prognosis than that of the other forms. Typical causes of death include complications of systemic therapeutic agents such as melphalan or systemic disease such as cardiovascular involvement.
  • Although most patients have a monoclonal paraproteinemia, they rarely have associated multiple myeloma. However, when myeloma is present, the patient generally has a poor prognosis.
  • Patients with cardiac or pulmonary involvement also have a poor prognosis.

Patient Education

  • Patients with lichen myxedematosus have a long-term, disfiguring, possibly disabling disorder. The risks and benefits of systemic therapy must be weighed carefully.
 


More on Lichen Myxedematosus

Overview: Lichen Myxedematosus
Differential Diagnoses & Workup: Lichen Myxedematosus
Treatment & Medication: Lichen Myxedematosus
Follow-up: Lichen Myxedematosus
Multimedia: Lichen Myxedematosus
References
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References

  1. Montgomery H, Underwood LJ. Lichen myxedematosus; differentiation from cutaneous myxedemas or mucoid states. J Invest Dermatol. Mar 1953;20(3):213-36. [Medline].

  2. Yaron M, Yaron I, Yust I, Brenner S. Lichen myxedematosus (scleromyxedema) serum stimulates hyaluronic acid and prostaglandin E production by human fibroblasts. J Rheumatol. Feb 1985;12(1):171-5. [Medline].

  3. Hill TG, Crawford JN, Rogers CC. Successful management of lichen myxedematosus. Report of a case. Arch Dermatol. Jan 1976;112(1):67-9. [Medline].

  4. Kaymen AH, Nasr A, Grekin RC. The use of carbon dioxide laser in lichen myxedematosus. J Dermatol Surg Oncol. Aug 1989;15(8):862-5. [Medline].

  5. Jacob SE, Fien S, Kerdel FA. Scleromyxedema, a positive effect with thalidomide. Dermatology. 2006;213(2):150-2. [Medline].

  6. Rongioletti F, Zaccaria E, Cozzani E, Parodi A. Treatment of localized lichen myxedematosus of discrete type with tacrolimus ointment. J Am Acad Dermatol. Mar 2008;58(3):530-2. [Medline].

  7. Sansbury JC, Cocuroccia B, Jorizzo JL, Gubinelli E, Gisondi P, Girolomoni G. Treatment of recalcitrant scleromyxedema with thalidomide in 3 patients. J Am Acad Dermatol. Jul 2004;51(1):126-31. [Medline].

  8. Horn KB, Horn MA, Swan J, Singhal S, Guitart J. A complete and durable clinical response to high-dose dexamethasone in a patient with scleromyxedema. J Am Acad Dermatol. Aug 2004;51(2 Suppl):S120-3. [Medline].

  9. Howsden SM, Herndon JH Jr, Freeman RG. Lichen myxedematosus. A dermal infiltrative disorder responsive to cyclophosphamide therapy. Arch Dermatol. Oct 1975;111(10):1325-30. [Medline].

  10. Chanda JJ. Scleromyxedema. Cutis. Nov 1979;24(5):549-52. [Medline].

  11. Dinneen AM, Dicken CH. Scleromyxedema. J Am Acad Dermatol. Jul 1995;33(1):37-43. [Medline].

  12. Gonzalez J, Palangio M, Schwartz J, Klainer AS, Bisaccia E. Scleromyxedema with dermato-neuro syndrome. J Am Acad Dermatol. May 2000;42(5 Pt 2):927-8. [Medline].

  13. Kovary PM, Vakilzadeh F, Macher E, Zaun H, Merk H, Goerz G. Monoclonal gammopathy in scleredema. Observations in three cases. Arch Dermatol. Sep 1981;117(9):536-9. [Medline].

  14. Lang E, Goos M. [Internal disease findings in Arndt-Gottron scleromyxedema]. Dtsch Med Wochenschr. May 23 1986;111(21):820-3. [Medline].

  15. Lin YC, Wang HC, Shen JL. Scleromyxedema: An experience using treatment with systemic corticosteroid and review of the published work. J Dermatol. Mar 2006;33(3):207-10. [Medline].

  16. Picascia DD, Magid ML, Minkin RB. Pruritic papular eruption. Papular mucinosis (lichen myxedematosus). Arch Dermatol. Jul 1989;125(7):986-7, 990. [Medline].

  17. Rongioletti F. Lichen myxedematosus (papular mucinosis): new concepts and perspectives for an old disease. Semin Cutan Med Surg. Jun 2006;25(2):100-4. [Medline].

  18. Rongioletti F, Rebora A. Updated classification of papular mucinosis, lichen myxedematosus, and scleromyxedema. J Am Acad Dermatol. Feb 2001;44(2):273-81. [Medline].

  19. Truhan AP, Roenigk HH Jr. Lichen myxedematosus. An unusual case with rapid progression and possible internal involvement. Int J Dermatol. Mar 1987;26(2):91-5. [Medline].

  20. Wright RC, Franco RS, Denton D, Blaney DJ. Scleromyxedema. Arch Dermatol. Jan 1976;112(1):63-6. [Medline].

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Further Reading

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Keywords

papular mucinosis, scleromyxedema, myxedematosus, plasma cell dyscrasia

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Contributor Information and Disclosures

Author

Elizabeth A Liotta, MD, Assistant Professor, Department of Dermatology, Uniformed Services University of the Health Sciences
Elizabeth A Liotta, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

Medical Editor

Mark W Cobb, MD, Consulting Staff, WNC Dermatological Associates
Mark W Cobb, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and American Society of Dermatopathology
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: 3M Pharmaceutical Grant/research funds Other; Graceway Pharmaceuticals Grant/research funds Other

Managing Editor

Edward F Chan, MD, Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine
Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

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