Ann Dermatol.  2015 Apr;27(2):133-141. 10.5021/ad.2015.27.2.133.

Periadnexal Mucin as an Additional Histopathologic Feature of Chronic Eczematous Dermatitis

• Lee NR
• Kim JH
• Park HY
• Yoon NY
• Ahn SK

• KMID: 2264801
• DOI: http://doi.org/10.5021/ad.2015.27.2.133

Abstract

BACKGROUND
Cutaneous mucinoses are a heterogeneous group of disorders characterized by an abnormal amount of mucin in the skin. However, the pathomechanism of an excessive mucin deposition in the skin is still unknown. Eczematous dermatitis is sub-classified histologically into acute, subacute, and chronic variants. The characteristic histopathologic findings for chronic eczema are variable. However, periadnexal mucin deposition is not known as a feature of chronic eczema.
OBJECTIVE
To evaluate the presence of periadnexal mucin deposition in chronic eczematous dermatitis.
METHODS
We analyzed the skin biopsy specimens from 36 patients who were pathologically diagnosed with chronic eczematous dermatitis. Alcian blue, colloidal iron, and periodic acid-Schiff stains were used to evaluate the mucin deposition in histologic sections. Two dermatologists and two dermatopathologists evaluated the degree of mucin deposition using a 4-point scale.
RESULTS
Various amounts of mucin deposition were observed in the periadnexal area of patients who were diagnosed with chronic eczema. Mucin deposition was more visible after staining with mucin-specific stains. Evaluation of the staining analysis scores revealed that the staining intensities were significantly higher in patients with chronic eczema than age- and site-matched controls (normal, acute to subacute eczema, and psoriasis vulgaris).
CONCLUSION
Periadnexal mucin (secondary mucinoses) may be an additional finding of chronic eczematous dermatitis.

Keyword

Eczema; Periadnexal mucin; Mucinoses

MeSH Terms

Alcian Blue
Biopsy
Colloids
Coloring Agents
Eczema*
Humans
Iron
Mucinoses
Mucins*
Psoriasis
Skin
Alcian Blue
Colloids
Coloring Agents
Iron
Mucins

Figure

• 

  Fig. 1 Pathology of a 56-year-old male who is diagnosed with chronic eczema. (A) Periadnexal mucin deposition (H&E, ×40), (B) mucin deposition is more visible when the slide is stained with colloidal iron (×40), and (C) the periodic acid-Schiff (PAS) staining is negative. These findings indicate that the mucin around the periadnexal area is dermal mucin, not epithelial mucin (PAS, ×40).

• 

  Fig. 2 Pathology of a 61-year-old male who is diagnosed with lichen simplex chronicus. (A) Chronic eczema showing periadnexal mucin deposition (H&E, ×40), (B) the mucin deposition is clearly visible after staining with colloidal iron and (C) Alcian blue (×40), and (D) the periodic acid-Schiff (PAS) staining is negative (×40).

• 

  Fig. 3 Pathology of a 5-year-old male who is diagnosed with atopic dermatitis. (A) Chronic eczema showing periadnexal mucin deposition (H&E, ×40), (B) the mucin deposition is more prominent after staining with colloidal iron, and (C) Alcian blue (×200).

• 

  Fig. 4 Pathology of the control samples that are diagnosed with normal skin or acute eczema. Mucin deposition is less visible in the control samples. (A) Normal skin (H&E, ×40), (B) normal skin (colloidal iron, ×40), (C) acute eczema (H&E, ×40), and (D) acute eczema (colloidal iron, ×40).

• 

  Fig. 5 Pathology of the control samples that are diagnosed with psoriasis vulgaris. (A) H&E (×40), (B) periodic acid-Schiff (×40), (C) Alcian blue (×40), and (D) colloidal iron (×40) staining are negative.

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  Fig. 6 Pathology of the patients diagnosed with chronic eczema with their hair follicles in the specimen (colloidal iron, ×100). A, B: weak, C, D: moderate, E, F: strong.

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  Fig. 7 Physician assessment of the mucin deposition using a 4-point scale. The staining intensities are significantly higher in patients with chronic eczema compared to those with acute eczema, psoriasis, or normal skin (**p<0.01).

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