Case Number : Case 2988 - 20 December 2021 Posted By: Dr. Mona Abdel-Halim

Thickened, edematous collagen fibres separated by mucin = scleredema.

Maybe post- streptococcal infection or associated with diabetes melitus 

Superficial and deep perivascular infiltrate with mucin, there also appears to be subtle interface pathology. Makes me think of tumid LE. 

Agree with Meenakshi. Tumid LE is an important differential. Clinical correlation is needed.

usually in tumid lupus there must be no vacuolar interface changes and we see superficial and mid dermal perivascular and peri eccrine lymphocytic infiltrates with a few plasma cells. since some amount of vacuolar interface changes are seen could be SLE.

However i am not against Tumid LE

I agree with tumid LE. 

In scleredema of Bushcke the skin changes are confluent and uniform rather than forming discrete plaques as in this case.

Sorry. I don’t know what this is. Very interesting case  Waiting for the answer. 

What about Reticular erythematous mucinosis (REM), ‘midline mucinosis’ or ‘plaque-like cutaneous mucinosis’?

I don’t know the lepromatous follicular mucinosis...but could this be the case? I’m stumbling around in the dark. 

19 hours ago, vincenzo said:

I don’t know the lepromatous follicular mucinosis...but could this be the case? I’m stumbling around in the dark. 

The pseudo-lepromatous form of follicular mucinosis is nearly always seen in older patients with CTCL-associated follicular mucinosis.  I think the inflammation and distribution of mucin in this case is rather too diffuse to be called follicular mucinosis, which is why I am leaning more towards lupus.

Thank you all.

Clinicopathological correlation was consistent with tumid LE.