10.5826/dpc.1303a150
text/xml
2160-9381
2932
en
Daniel  Morgado-Carrasco 
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Brownish-Yellow Dots as a Dermoscopic Sign of Follicular Mucinosis
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2023-07-31
2022-10-21
2023-07-31
2023-08-24
e2023150
Dermatol Pract Concept
Daniel  Morgado-Carrasco 
2023/07/31
10.5826/dpc.1303a150
e2023150
Dermatology Department, Hospital de Figueres, Fundació Salut Empordà, Girona, Spain
2160-9381
en
e2023150
Yamagishi H, Ota M, Nobeyama Y, Asahina A. Case of follicular mucinosis showing brownish yellow and red dots via dermoscopy. Clin Case Rep. 2022;10(5). DOI: 10.1002/ccr3.5815. PMID: 35600022. PMCID: PMC9109645.
Brownish-Yellow Dots as a Dermoscopic Sign of Follicular Mucinosis
https://dpcj.org/index.php/dpc/article/download/2932/2255
                 Brownish-Yellow Dots as a Dermoscopic
                      Sign of Follicular Mucinosis
                                Javier de la Iglesia Martin1, Jaime Piquero-Casals2,
                                   Angels Quera3, Daniel Morgado-Carrasco1,3


1 Dermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
2 Dermik, Clínica Dermatológica Multidisciplinar, Barcelona, Spain
3 Dermatology Department, Hospital de Figueres, Fundació Salut Empordà, Girona, Spain



Citation: de la Iglesia Martin J, Piquero-Casals J, Quera A, Morgado-Carrasco D. Brownish-Yellow Dots as a Dermoscopic Sign of
Follicular Mucinosis Dermatol Pract Concept. 2023;13(3):e2023150.
DOI: https://doi.org/10.5826/dpc.1303a150
Accepted: January 14, 2023; Published: July 2023
Copyright: ©2023 de la Iglesia Martin et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Daniel Morgado-Carrasco, Hospital clínic de Barcelona, Villarroel 170, Barcelona (08036),
Tel. (+34) 935 464 710 Fax (+34) 935 464 729 Email: morgadodniel8@gmail.com




Case Presentation                                                        corticosteroids and hydroxychloroquine 400 mg/day were
                                                                         started, and long-term follow-up was recommended.
A 40-year-old man presented with a 2-year history of
well defined, erythematous and alopecic plaques, together
with alopecic patches on both shins. Dermoscopy showed                   Teaching Point
medium-size brownish-yellow dots, arboriform vessels and
                                                                         Follicular mucinosis is a rare inflammatory dermatosis
patchy homogenous ivory-white areas (Figure 1). ­Laboratory
                                                                         ­characterized by abnormal deposition of mucin on hair fol-
tests including blood count, antinuclear antibodies, Ro/La
                                                                         licles [1]. There are two subtypes: idiopathic and associated
antibodies, thyroid function and serum protein electropho-
                                                                         with cutaneous lymphomas or hematological malignancies.
resis, together with serologies for syphilis, Lyme disease,
                                                                              The diagnosis of follicular mucinosis can be challeng-
hepatitis B and C virus, and HIV, and chest X-ray were nor-
                                                                         ing. Dermoscopic features of follicular mucinosis have
mal or negative. A punch biopsy revealed a follicular and
                                                                         scarcely been described. Dermoscopy may reveal white
perifollicular lymphocytic infiltrate with no cellular atypia,
                                                                         homogenous patches surrounded by a yellow border, in-
and deposition of an amorphic substance around follicles in
                                                                         terfollicular red dots and the tooth paste sign1 (white ge-
the dermis. Alcian blue at pH 2.5 confirmed the presence of
                                                                         latinous material along hair shafts). Yamagishi et al Haga
mucin (Figure 2). Based on clinicopathological characteris-
                                                                         clic o pulse aquí para escribir texto. reported perifollicular
tics a diagnosis of follicular mucinosis was made. Topical
                                                                         medium-size brownish-yellow dots, which were also seen in




Image Letter | Dermatol Pract Concept. 2023;13(3):e2023150                                                                           1
          A                                                                    B




         Figure 1. (A) Follicular mucinosis. Well-defined, erythematous alopecic plaques, and alopecic patches on both shins.
         (B) Dermoscopy reveals multiple medium-size brownish-yellow dots, and arboriform vessels. Scattered homogenous
         white areas can also be seen.




    A                                                                  B




 Figure 2. (A) Histopathologic picture. Lymphocytic infiltrate and amorphic substance around hair follicles. No cellular atypia was seen.
 (B) Alcian blue at pH 2.5 confirmed the presence of mucin.



our patient [2]. These structures can also be observed in dis-         References
coid lupus erythematosus, among other dermatoses.
    Dermoscopy may be helpful in the diagnosis of follicular            1. Mumford BP, Ryan A, Chong AH, Lasocki A. Follicular muci-
                                                                           nosis with novel dermoscopic finding: the toothpaste sign. Clin
mucinosis, and medium-size brownish-yellow dots can be a
                                                                           Exp Dermatol. 2022;47(5):969-970. DOI: 10.1111/ced.15083.
novel dermoscopic sign.
                                                                           PMID: 34978345.
                                                                        2. Yamagishi H, Ota M, Nobeyama Y, Asahina A. Case of follic-
                                                                           ular mucinosis showing brownish yellow and red dots via der-
                                                                           moscopy. Clin Case Rep. 2022;10(5). DOI: 10.1002/ccr3.5815.
                                                                           PMID: 35600022. PMCID: PMC9109645.




2                                                                             Image Letter | Dermatol Pract Concept. 2023;13(3):e2023150
