Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Art & Psychiatry
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Conference Oration
Conference Summary
Continuing Medical Education
Cosmetic Dermatology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
Editor Speaks
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Miscellaneous Letter
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News & Views
Observation Letter
Observation Letters
Original Article
Original Contributions
Pattern of Skin Diseases
Pediatric Dermatology
Pediatric Rounds
Presedential Address
Presidential Address
Presidents Remarks
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Review Article
Review Articles
Revision Corner
Self Assessment Programme
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Study Letter
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapy Letter
View Point
What’s new in Dermatology
View/Download PDF
Letter to the Editor
doi: 10.4103/0378-6323.60567
PMID: 20228561

Self-healing juvenile cutaneous mucinosis manifesting with subcutaneous nodules

Arti Nanda1 , Mohamed K Selim1 , Humoud Al-Sabah1 , Vivek Singhal2 , Kusum Kapila3
1 As'ad Al-Hamad Dermatology Center, Al-Sabah Hospital, Kuwait University, India
2 Department of Dermatology Yiaco Appollo Hospital, Kuwait University, India
3 Department of Pathology, Faculty of Medicine, Kuwait University, India

Correspondence Address:
Arti Nanda
P.O. Box: 6759, Salmiya, 22078, Salmiya
How to cite this article:
Nanda A, Selim MK, Al-Sabah H, Singhal V, Kapila K. Self-healing juvenile cutaneous mucinosis manifesting with subcutaneous nodules . Indian J Dermatol Venereol Leprol 2010;76:198-199
Copyright: (C)2010 Indian Journal of Dermatology, Venereology, and Leprology


Self-healing juvenile cutaneous mucinosis (SHJCM) is characterized by a rapid onset of papules, plaques, or nodules on the face, periarticular region, abdomen, and thighs. Lesions are associated with absent-to-mild inflammatory symptoms and in most cases show spontaneous complete resolution in weeks to months. Since its first report in 1973, [1] around 15 cases have been reported in the literature. [2],[3],[4],[5] The exact pathogenesis of SHJCM is not clear. We report an additional case of SHJCM in a two and a half years old female child, who presented with subcutaneous nodules clinically with histopathological changes affecting the subcutaneous tissue.

A two and a half years old girl presented with progressive asymptomatic nodules preceded by minor trauma on the face and scalp, followed by similar lesions on the neck, forearms, wrists, and back of 6-months duration. She was delivered at 34 weeks by normal vaginal delivery with a birth weight of 1.2 kg. Antenatal history of the mother and family history were unremarkable. There was no history of accompanying constitutional or systemic symptoms. Her physical and mental development was appropriate for her age.

On examination, her height and weight were at 50th percentile. She was observed to have around 12 subcutaneous, mildly erythematous, firm, non-tender nodules up to 5 cm in diameter present on scalp, forehead, cheeks, neck, forearms, wrists, knuckle areas, and back [Figure - 1]. An excision biopsy was performed of two of the nodules, one on left forearm and another on the scalp. The biopsy specimens of both nodules stained with hematoxylin-eosin stain revealed a normal epidermis, and an unencapsulated deep dermal and subcutaneous mass composed of septolobular panniculitis-like distribution of mixed inflammatory cells within a myxoid stroma. Multiple epithelioid gangliocyte-like cells within the pool of myxoid stroma were seen [Figure - 2]a. The section stained with alcian blue at pH 2.5 confirmed the mucin deposition [Figure - 2]b. Various other investigations including complete blood counts, serum biochemistry, antinuclear antibodies, urinalysis, and X-ray of the skull were normal.

On follow-up, 2-months later the lesions were observed to regress in size. At 5-month follow-up, all the lesions had resolved without any residual effect [Figure - 3]. One year later, after the regression of all the lesions, she continues to be in a good general health without any recurrence of lesions.

SHJCM is a distinct variant of primary cutaneous mucinosis that can be differentiated from other variants of primary cutaneous mucinosis by a younger age of onset, rapid appearance of papules and/or nodules that tend to show spontaneous resolution. Nagaraj and colleagues [2] recently described the clinicopathological characteristics of three cases of SHJCM and reviewed the literature on 10 previously reported cases of SHJCM. The ages of the patients reported have ranged from 13 months to 15 years. Clinically, the skin lesions in SHJCM are of three types and include translucent to ivory white, grouped papules; deep-seated nodules; and periorbital or zygomatic edema. The striking feature is the self-healing nature of the lesions within weeks to months. Our patient is the classical example of nodular variant of SHJCM. A skin biopsy of the nodular lesions like our patient may show the diffuse septolobular panniculitis pattern with mucin deposition and the presence of epithelioid gangliocyte-like giant cells in myxoid stroma. Histologically, such cases may need to be differentiated from panniculitis, proliferative fasciitis, and other entities where gangliocyte-like giant cells are noted. [2] The clinical presentation with self-healing nature of skin lesions and mucin deposition in papillary and reticular dermis and presence of gangliocyte-like giant cells within the myxoid stroma help to differentiate SHJCM from proliferative fasciitis and other types of panniculitis. In contrast to mucinosis affecting adults, SHJCM runs a benign course and is not associated with disorders such as paraproteinemia, bone marrow plasmacytosis, or thyroid disorder. However, incidental associations with systemic lupus erythematous; fever and arthralgias; nephroblastoma; and bilateral carpel tunnel syndrome have been reported. [2],[3],[4],[5] None of these conditions were present in our patient. The etiopathogenesis of SHJCM is not settled. Abnormal fibroblast proliferation and mucin production are postulated to be secondary to a reactive or reparative response to a chronic antigenic stimulation, such as viral infection or inflammation.

Colomb D, Racouchot J, Vittori F. Mucinose d'evolution regressive sans paraproteine chez une jeune fille. Lyon Med 1973;230:273-81.
[Google Scholar]
Nagaraj LV, Fangman W, White WL, Woosley JT, Prose N, Selim MA, et al. Self-healing juvenile cutaneous mucinosis: Cases highlighting subcutaneous/fascial involvement. J Am Acad Dermatol 2006;55:1036-43.
[Google Scholar]
Caputo R, Grimalt R, Gelmetti C. Self-healing juvenile cutaneous mucinosis. Arch Dermatol 1995;131:459-61.
[Google Scholar]
Eskreis BD, Bronson DM. Cutaneous mucinosis in a child with systemic lupus erythematosus. Pediatr Dermatol 1992;9:259-63.
[Google Scholar]
Bachmeyer C, Chesneau AM, Loirat C, Asensi D, Babinet JM, Blum L. Papulonodular mucinosis in a child with systemic lupus erythematosus. Pediatr Dermatol 2007;24:585-6.
[Google Scholar]

Fulltext Views

PDF downloads
Show Sections