Alopecia mucinosa, also known as Follicular mucinosis, Mucinosis follicularis, Pinkus' follicular mucinosis, and Pinkus' follicular mucinosis–benign primary form, is a skin disorder that generally presents, but not exclusively, as erythematous plaques or flat patches without hair primarily on the scalp, neck and face.[1]: 649 [2]: 188 This can also be present on the body as a follicular mucinosis and may represent a systemic disease.[3][4]
Alopecia mucinosa is divided into three different variants, primary acute, primary chronic, and secondary alopecia mucinosa.[5]
Signs and symptoms
Follicle papules and alopecia are the two main clinical signs of alopecia mucinosa. There may be patches of follicular papules, plaques, and nodules. In addition to the usual erythema and scaling, active lesions might occasionally express mucous material. The most frequently involved areas are the face and the scalp.[6]
Causes
Although the precise pathophysiology is uncertain, it has been suggested that cell-mediated immunity and circulating immune complexes play a part in responding to persistent antigens like Staphylococcus aureus.[7]
Diagnosis
Alopecia mucinosa patients require many skin biopsy samples for examination. Alopecia mucinosa is characterized by follicular degeneration and a buildup of mucin inside the follicles.[6]
Classification
The primary acute form of alopecia mucinosa is more common in children and young adults, characterized by isolated lesions on the scalp and skull that go away on their own in a short amount of time. The primary chronic variant of alopecia mucinosa is more common in slightly older age groups, has many disseminated lesions, and has a longer course with recurrent recurrences after treatment. A variety of benign and malignant illnesses can lead to secondary alopecia mucinosa.[5]
Rongioletti, Franco; De Lucchi, Simona; Meyes, Dan; Mora, Marco; Rebora, Alfredo; Zupo, Simonetta; Cerruti, Giannamaria; Patterson, James W. (2009-11-24). "Follicular mucinosis: a clinicopathologic, histochemical, immunohistochemical and molecular study comparing the primary benign form and the mycosis fungoides-associated follicular mucinosis". Journal of Cutaneous Pathology. 37 (1). Wiley: 15–19. doi:10.1111/j.1600-0560.2009.01338.x. ISSN0303-6987. PMID19615011.
Zvulunov, Alex; Shkalim, Vered; Ben-Amitai, Dan; Feinmesser, Meora (2012). "Clinical and histopathologic spectrum of alopecia mucinosa/follicular mucinosis and its natural history in children". Journal of the American Academy of Dermatology. 67 (6). Elsevier BV: 1174–1181. doi:10.1016/j.jaad.2012.04.015. ISSN0190-9622. PMID22579407.
