Obesity-associated lymphoedematous mucinosis

Franco Rongioletti, Pietro Donati, Ada Amantea, Gerardo Ferrara, Martina Montinari, Francesca Santoro, Aurora Parodi

Research output: Contribution to journalArticle

Abstract

Background: Mucin deposition on the shins is considered as an indicator of pretibial myxoedema, which is typically seen in patients with Graves' disease. Objective: The purpose of this study was to report the clinical and histopathological features of a group of patients with pretibial mucinosis in the absence of thyroid disease. Methods: Five patients are included in this series and studied both clinically and histologically and compared with similar cases in the literature. Results: All patients were middle aged or elderly. Four patients were women. They were characterized clinically by morbid obesity and bilateral lower extremity pitting oedema sparing the feet. Semitranslucent papules and/or nodules and sometimes vesicles were found on the shins. Characteristic histological features include (i) hyperorthokeratosis with epidermal atrophy and effacement of the rete ridge pattern, (ii) oedema in the papillary and upper part of the reticular dermis with mucin deposition stained positively with alcian blue and colloidal iron, (iii) angioplasia in the upper part of dermis with upward-running, increased and thickened capillary vessels and (iv) variable fibrosis in the reticular dermis with separation of collagen bundles and increased stellate or linear fibroblasts. A hypocaloric diet was given in two cases, and an important weight loss was observed, which was accompanied by a marked improvement of the pretibial mucinosis. Conclusions: Pretibial mucinosis is a histological feature associated with morbid obesity and lymphoedematous features of the legs that should be distinguished from true pretibial myxoedema. The term of 'obesity-associated lymphoedematous mucinosis' seems to be appropriate for this condition. Rongioletti F, Donati P, Amantea A, Ferrara G, Montinari M, Santoro F, Parodi A. Obesity-associated lymphoedematous mucinosis.

Original languageEnglish
Pages (from-to)1089-1094
Number of pages6
JournalJournal of Cutaneous Pathology
Volume36
Issue number10
DOIs
Publication statusPublished - Oct 2009

Fingerprint

Mucinoses
Obesity
Dermis
Myxedema
Morbid Obesity
Mucins
Edema
Alcian Blue
Graves Disease
Thyroid Diseases
Atrophy
Foot
Weight Loss
Lower Extremity
Leg
Fibrosis
Collagen
Iron
Fibroblasts
Diet

ASJC Scopus subject areas

  • Dermatology
  • Pathology and Forensic Medicine
  • Histology

Cite this

Rongioletti, F., Donati, P., Amantea, A., Ferrara, G., Montinari, M., Santoro, F., & Parodi, A. (2009). Obesity-associated lymphoedematous mucinosis. Journal of Cutaneous Pathology, 36(10), 1089-1094. https://doi.org/10.1111/j.1600-0560.2008.01239.x

Obesity-associated lymphoedematous mucinosis. / Rongioletti, Franco; Donati, Pietro; Amantea, Ada; Ferrara, Gerardo; Montinari, Martina; Santoro, Francesca; Parodi, Aurora.

In: Journal of Cutaneous Pathology, Vol. 36, No. 10, 10.2009, p. 1089-1094.

Research output: Contribution to journalArticle

Rongioletti, F, Donati, P, Amantea, A, Ferrara, G, Montinari, M, Santoro, F & Parodi, A 2009, 'Obesity-associated lymphoedematous mucinosis', Journal of Cutaneous Pathology, vol. 36, no. 10, pp. 1089-1094. https://doi.org/10.1111/j.1600-0560.2008.01239.x
Rongioletti F, Donati P, Amantea A, Ferrara G, Montinari M, Santoro F et al. Obesity-associated lymphoedematous mucinosis. Journal of Cutaneous Pathology. 2009 Oct;36(10):1089-1094. https://doi.org/10.1111/j.1600-0560.2008.01239.x
Rongioletti, Franco ; Donati, Pietro ; Amantea, Ada ; Ferrara, Gerardo ; Montinari, Martina ; Santoro, Francesca ; Parodi, Aurora. / Obesity-associated lymphoedematous mucinosis. In: Journal of Cutaneous Pathology. 2009 ; Vol. 36, No. 10. pp. 1089-1094.
@article{b8785c6f78854d109a86efc5be7eda8d,
title = "Obesity-associated lymphoedematous mucinosis",
abstract = "Background: Mucin deposition on the shins is considered as an indicator of pretibial myxoedema, which is typically seen in patients with Graves' disease. Objective: The purpose of this study was to report the clinical and histopathological features of a group of patients with pretibial mucinosis in the absence of thyroid disease. Methods: Five patients are included in this series and studied both clinically and histologically and compared with similar cases in the literature. Results: All patients were middle aged or elderly. Four patients were women. They were characterized clinically by morbid obesity and bilateral lower extremity pitting oedema sparing the feet. Semitranslucent papules and/or nodules and sometimes vesicles were found on the shins. Characteristic histological features include (i) hyperorthokeratosis with epidermal atrophy and effacement of the rete ridge pattern, (ii) oedema in the papillary and upper part of the reticular dermis with mucin deposition stained positively with alcian blue and colloidal iron, (iii) angioplasia in the upper part of dermis with upward-running, increased and thickened capillary vessels and (iv) variable fibrosis in the reticular dermis with separation of collagen bundles and increased stellate or linear fibroblasts. A hypocaloric diet was given in two cases, and an important weight loss was observed, which was accompanied by a marked improvement of the pretibial mucinosis. Conclusions: Pretibial mucinosis is a histological feature associated with morbid obesity and lymphoedematous features of the legs that should be distinguished from true pretibial myxoedema. The term of 'obesity-associated lymphoedematous mucinosis' seems to be appropriate for this condition. Rongioletti F, Donati P, Amantea A, Ferrara G, Montinari M, Santoro F, Parodi A. Obesity-associated lymphoedematous mucinosis.",
author = "Franco Rongioletti and Pietro Donati and Ada Amantea and Gerardo Ferrara and Martina Montinari and Francesca Santoro and Aurora Parodi",
year = "2009",
month = "10",
doi = "10.1111/j.1600-0560.2008.01239.x",
language = "English",
volume = "36",
pages = "1089--1094",
journal = "Journal of Cutaneous Pathology",
issn = "0303-6987",
publisher = "Wiley-Blackwell",
number = "10",

}

TY - JOUR

T1 - Obesity-associated lymphoedematous mucinosis

AU - Rongioletti, Franco

AU - Donati, Pietro

AU - Amantea, Ada

AU - Ferrara, Gerardo

AU - Montinari, Martina

AU - Santoro, Francesca

AU - Parodi, Aurora

PY - 2009/10

Y1 - 2009/10

N2 - Background: Mucin deposition on the shins is considered as an indicator of pretibial myxoedema, which is typically seen in patients with Graves' disease. Objective: The purpose of this study was to report the clinical and histopathological features of a group of patients with pretibial mucinosis in the absence of thyroid disease. Methods: Five patients are included in this series and studied both clinically and histologically and compared with similar cases in the literature. Results: All patients were middle aged or elderly. Four patients were women. They were characterized clinically by morbid obesity and bilateral lower extremity pitting oedema sparing the feet. Semitranslucent papules and/or nodules and sometimes vesicles were found on the shins. Characteristic histological features include (i) hyperorthokeratosis with epidermal atrophy and effacement of the rete ridge pattern, (ii) oedema in the papillary and upper part of the reticular dermis with mucin deposition stained positively with alcian blue and colloidal iron, (iii) angioplasia in the upper part of dermis with upward-running, increased and thickened capillary vessels and (iv) variable fibrosis in the reticular dermis with separation of collagen bundles and increased stellate or linear fibroblasts. A hypocaloric diet was given in two cases, and an important weight loss was observed, which was accompanied by a marked improvement of the pretibial mucinosis. Conclusions: Pretibial mucinosis is a histological feature associated with morbid obesity and lymphoedematous features of the legs that should be distinguished from true pretibial myxoedema. The term of 'obesity-associated lymphoedematous mucinosis' seems to be appropriate for this condition. Rongioletti F, Donati P, Amantea A, Ferrara G, Montinari M, Santoro F, Parodi A. Obesity-associated lymphoedematous mucinosis.

AB - Background: Mucin deposition on the shins is considered as an indicator of pretibial myxoedema, which is typically seen in patients with Graves' disease. Objective: The purpose of this study was to report the clinical and histopathological features of a group of patients with pretibial mucinosis in the absence of thyroid disease. Methods: Five patients are included in this series and studied both clinically and histologically and compared with similar cases in the literature. Results: All patients were middle aged or elderly. Four patients were women. They were characterized clinically by morbid obesity and bilateral lower extremity pitting oedema sparing the feet. Semitranslucent papules and/or nodules and sometimes vesicles were found on the shins. Characteristic histological features include (i) hyperorthokeratosis with epidermal atrophy and effacement of the rete ridge pattern, (ii) oedema in the papillary and upper part of the reticular dermis with mucin deposition stained positively with alcian blue and colloidal iron, (iii) angioplasia in the upper part of dermis with upward-running, increased and thickened capillary vessels and (iv) variable fibrosis in the reticular dermis with separation of collagen bundles and increased stellate or linear fibroblasts. A hypocaloric diet was given in two cases, and an important weight loss was observed, which was accompanied by a marked improvement of the pretibial mucinosis. Conclusions: Pretibial mucinosis is a histological feature associated with morbid obesity and lymphoedematous features of the legs that should be distinguished from true pretibial myxoedema. The term of 'obesity-associated lymphoedematous mucinosis' seems to be appropriate for this condition. Rongioletti F, Donati P, Amantea A, Ferrara G, Montinari M, Santoro F, Parodi A. Obesity-associated lymphoedematous mucinosis.

UR - http://www.scopus.com/inward/record.url?scp=69449100819&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=69449100819&partnerID=8YFLogxK

U2 - 10.1111/j.1600-0560.2008.01239.x

DO - 10.1111/j.1600-0560.2008.01239.x

M3 - Article

C2 - 19222694

AN - SCOPUS:69449100819

VL - 36

SP - 1089

EP - 1094

JO - Journal of Cutaneous Pathology

JF - Journal of Cutaneous Pathology

SN - 0303-6987

IS - 10

ER -