Nofal et al reported criteria for making the diagnosis of lichen myxedematosus. The authors are from Zagazig University, Al-Haud Al-Marsoud Dermatology Hospital and Al-Azhar Unviersity in Cairo.
Patient selection: suspected lichen myxedematosus
(1) firm, waxy, closely-set papules that coalesce into indurated plaques or nodules
(2) diffuse deposition of mucin in the dermis and fibroblastic proliferation, with or without fibrosis
(1) monoclonal gammopathy
(2) thyroid disease (usually hypothyroidism)
(3) HIV infection
(4) hepatitis C viral infection
(5) peripheral eosinophilia
(6) thymic or hepatocellular carcinoma
(7) interstitial granuloma annulare-like pattern
A definite diagnosis requires both of the constant features.
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