Mucin in the dermis

A 68-year-old female patient developed pale hyperaemic, few millimeters large confluent papules with a shiny surface forming large plaques, localized on the face, neck, trunk and the proximal part of the upper limbs. Based on the clinical symptoms, differential diagnoses of papular mucinosis, amyloidosis, interstitial granulomatous dermatitis, granuloma annulare, photocontact eczema, systemic lupus erythematosus, dermatomyositis, mycosis fungoides, and polymorphic light exanthema arose. Diagnosis of interstitial granulomatous dermatitis was made on the base of, mucin positivity in the dermis in association with granulomatous inflammation, Apart from myelodysplastic syndrome, no other underlying disease or medicinal conditions could be proven. Local powerful corticosteroid, PUVA cream therapy did not result in sufficient results. With systemic corticosteroid and acitretin, the skin symptoms improved. In this case report, the authors describe in detail the currently accepted classification of mucinoses and review the rare papular mucinosis and interstitial granulomatosus dermatitis.