Nofal et al reported a classification and grading system for lichen myxedematosus which has prognostic significance. The authors are from Zagazig University, Al-Haud Al Marsoud Dermatology Hospital and Al-Azhar University in Cairo.
Parameters for classification:
(1) distribution of skin lesions
(2) systemic involvement
Distribution of Skin Lesions
Systemic Involvement
Subtype
localized or limited
none
pure cutaneous (A)
generalized or extensive
none
pure cutaneous (B)
localized or generalized
present
systemic (scleromyxedema)
The systemic subtype may be disabling and can be fatal.
The subtype correlates with a grading system based on clinical severity.
Subtype
Severity
pure cutaneous, limited
mild (G1)
pure cutaneous, extensive
moderate (G2)
systemic
severe (G3)
G3 might be further subclassified based on disability and rate of change.
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