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Hypopigmented Papules and Nodules on the Trunk and Arms—Diagnosis
Arch Dermatol. 2004;140:121-126.
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Diagnosis: Papulonodular mucinosis (PNM) associated with systemic LE.
MICROSCOPIC FINDINGS AND CLINICAL COURSE
A biopsy specimen of a papule revealed a normal epidermis with a mild perifollicular lymphocytic infiltrate (Figure 2). There was increased dermal mucin dispersed between collagen bundles, as highlighted with a colloidal iron stain. Laboratory evaluation revealed an antinuclear antibody titer equal to or greater than 1:160 (speckled pattern); a VDRL slide test result of 1:2, with a negative fluorescent treponemal antibody absorption test result; and an elevated anticardiolipin antibody titer. Complement levels were within normal limits. Serologic tests were negative for antibodies to anti-DNA, ribonuclear protein, Sm, Ro, and La. Urinalysis showed rare white and red blood cells, trace blood, and 2+ protein. A 24-hour urine study revealed nephrotic-range proteinuria at 2760 mg/d (normal,  150 mg/d). A renal ultrasound failed to show any gross abnormalities. A renal biopsy specimen revealed mesangial lupus nephritis; therefore, prednisone and azathioprine therapy was initiated. With treatment, the patient's renal function improved . . . [Full Text of this Article] DISCUSSION
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Hypopigmented Papules and Nodules on the Trunk and Arms—Quiz Case
Debra M. Jih and Stephen C. Somach
Arch Dermatol. 2004;140(1):121-126.
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