{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:04:28Z","timestamp":1782846268473,"version":"3.54.5"},"reference-count":15,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Dermatol"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Acral persistent papular mucinosis (APPM) is a localized variant of lichen myxedematosus (LM) characterized by asymptomatic, flesh-colored papules primarily distributed on the hands and forearms. This chronic dermatosis, distinct from generalized mucinosis due to its lack of systemic involvement, remains underreported in medical literature.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n In this study, we present two cases of APPM to the limited pool of documented cases in the United States, highlighting its emerging recognition.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This is a case series of two patients presenting with asymptomatic papular eruptions on the hands and wrists, consistent with the typical presentation of APPM. Diagnostic confirmation via biopsy revealed focal cutaneous mucinosis. Comprehensive laboratory evaluations, including serum and urine protein electrophoresis, showed no evidence of underlying gammopathy in either patient.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Treatment modalities for APPM are limited and often ineffective. Unlike other forms of LM, APPM features are confined to skin lesions, posing primarily as a cosmetic concern with a favorable prognosis. Accurate diagnosis of this localized LM is crucial to differentiate it from the more severe, generalized form, scleromyxedema, which can have organ involvement and may become fatal. Notably, while spontaneous resolution is reported in LM, including discrete papular mucinosis, APPM typically persists without resolution even after extended follow-up.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n These cases underscore the importance of recognizing APPM and advocating for broader awareness and exploration of its clinical variability, etiology, and management strategies. With increasing recognition, the understanding of APPM can be enhanced, paving the way for optimized management and improved outcomes for affected individuals.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/77714","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T21:22:14Z","timestamp":1758057734000},"page":"e77714-e77714","source":"Crossref","is-referenced-by-count":0,"title":["Acral Persistent Papular Mucinosis in the United States: Case Series and Literature Review"],"prefix":"10.2196","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1353-5292","authenticated-orcid":false,"given":"Devin","family":"Miller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6215-1520","authenticated-orcid":false,"given":"Rachel","family":"Manci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1957-9472","authenticated-orcid":false,"given":"Jay","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1867-7653","authenticated-orcid":false,"given":"William","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6663-6672","authenticated-orcid":false,"given":"Daniel","family":"Lozeau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3128-6497","authenticated-orcid":false,"given":"James","family":"Briley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"issue":"2","key":"R1","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.clindermatol.2020.10.001","article-title":"Acral persistent papular mucinosis","volume":"39","author":"Rongioletti","journal-title":"Clin Dermatol"},{"issue":"5","key":"R2","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1111\/j.1610-0387.2010.07594.x","article-title":"Acral persistent papular mucinosis: a case report and literature review","volume":"9","author":"Luo","journal-title":"J Dtsch Dermatol Ges"},{"issue":"10","key":"R3","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1111\/1346-8138.16043","article-title":"Acral persistent papular mucinosis: a case report and summary of 24 Japanese cases","volume":"48","author":"Mori","journal-title":"J Dermatol"},{"issue":"2","key":"R4","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1002\/ccr3.2639","article-title":"A rare case of acral persistent papular mucinosis","volume":"8","author":"Toh","journal-title":"Clin Case Rep"},{"issue":"13","key":"R5","doi-asserted-by":"publisher","first-page":"3086","DOI":"10.12998\/wjcc.v11.i13.3086","article-title":"Solitary acral persistent papular mucinosis nodule: a case report and summary of eight Korean cases","volume":"11","author":"Park","journal-title":"World J Clin Cases"},{"issue":"11","key":"R6","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1001\/archderm.1986.01660230027002","volume":"122","author":"Rongioletti","journal-title":"Arch Dermatol"},{"issue":"2S1","key":"R7","doi-asserted-by":"publisher","first-page":"S10","DOI":"10.1016\/j.jaad.2016.03.046","article-title":"Acral persistent papular mucinosis (APPM): dermoscopy of an uncommon disease","volume":"76","author":"Navarrete-Dechent","journal-title":"J Am Acad Dermatol"},{"issue":"6","key":"R8","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1111\/j.1365-2230.2007.02490.x","article-title":"Multiple asymptomatic papules on the legs","volume":"32","author":"Madan","journal-title":"Clin Exp Dermatol"},{"issue":"4","key":"R9","doi-asserted-by":"publisher","first-page":"517","DOI":"10.5021\/ad.2016.28.4.517","article-title":"Acral persistent papular mucinosis with partial response to tacrolimus ointment","volume":"28","author":"Jun","journal-title":"Ann Dermatol"},{"issue":"6","key":"R10","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1016\/j.jaad.2004.07.002","article-title":"Acral persistent papular mucinosis","volume":"51","author":"Harris","journal-title":"J Am Acad Dermatol"},{"key":"R11","unstructured":"Berbaum M Litt JZ Bass J . Acral persistent papular mucinosis: a distinct dermal mucinosis. Presented at: Meeting of the American Academy of Dermatology; Dec 8, 2025; San Antonio, Texas. 1987."},{"issue":"6 Pt 1","key":"R12","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1016\/s0190-9622(08)80277-0","article-title":"Acral persistent papular mucinosis","volume":"27","author":"Fosko","journal-title":"J Am Acad Dermatol"},{"issue":"1","key":"R13","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1001\/archderm.140.1.121-a","article-title":"Flesh-colored papules on the wrists of a 61-year-old man","volume":"140","author":"Kineston","journal-title":"Arch Dermatol"},{"issue":"2","key":"R14","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1111\/j.1365-2230.2007.02621.x","article-title":"Spreading bumps\u2019 on hands of a Native American","volume":"33","author":"Sebastian","journal-title":"Clin Exp Dermatol"},{"issue":"6","key":"R15","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1002\/lsm.22368","article-title":"Treatment of acral persistent papular mucinosis using an Erbium-YAG laser","volume":"47","author":"Graves","journal-title":"Lasers Surg Med"}],"container-title":["JMIR Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/derma.jmir.org\/2025\/1\/e77714","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:09:59Z","timestamp":1782842999000},"score":1,"resource":{"primary":{"URL":"https:\/\/derma.jmir.org\/2025\/1\/e77714"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,16]]},"references-count":15,"URL":"https:\/\/doi.org\/10.2196\/77714","relation":{},"ISSN":["2562-0959"],"issn-type":[{"value":"2562-0959","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,16]]},"article-number":"v8i2e77714"}}