Papular mucinosis associated with generalized morphoea

A 67-year-old white man is described who had large sclerotic plaques with a violaceous border on his back and abdomen and a scleroderma-like induration on the legs, sparing the feet. Additionally, he had multiple skin- coloured, large, sometimes centrally depressed papules and nodules on the nape of the neck, back and upper limbs. These occurred in both the normal and sclerotic areas. Histologically, large amounts of focal mucin were seen in the upper dermis consistent with the diagnosis of papular mucinosis and associated with typical underlying features of scleroderma. No paraproteinaemia was found. We excluded scleromyxoedema on clinical, histopathological and laboratory grounds and diagnosed our patient as having generalized morphoea with papular mucinosis. We are aware of only two reports of large cutaneous deposits of mucin associated with scleroderma.