Lichen Myxedematosus Workup

Updated: Mar 11, 2019
  • Author: Elizabeth A Liotta, MD; Chief Editor: Dirk M Elston, MD  more...
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Workup

Laboratory Studies

Serum protein immunoelectrophoresis generally reveals the presence of a serum paraprotein (usually 7S-IgG) with lambda light chains.

Few patients may have myeloma or Waldenström macroglobulinemia.

Thyroid function test results are normal.

Findings of other laboratory test are usually normal.

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Imaging Studies

Chest radiographic findings are usually normal in healthy patients.

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Other Tests

In patients with systemic symptoms such as dysphagia, dyspnea, or neurologic symptoms, the specific systems affected should be evaluated.

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Histologic Findings

Lesions have large depositions of mucin in the dermis. Numerous plump stellate fibroblasts develop throughout the dermis. There is increased collagen deposition. The mucin stains with periodic acid-Schiff and Alcian blue at pH 2.5 but not pH 0.4, and it metachromatically stains with toluidine blue at pH 3.0. The mucin has been identified as hyaluronic acid, a nonsulfated acid mucopolysaccharide. [4]

Note the images below.

Low-power photomicrograph of a histopathologic spe Low-power photomicrograph of a histopathologic specimen demonstrates the wide separation of the collagen fibers near the large collection of mucin in the dermis.
High-power photomicrograph of a histopathologic sp High-power photomicrograph of a histopathologic specimen reveals the large collections of mucin and plump stellate fibroblasts in the dermis.
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