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2025, Number 3

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Dermatología Cosmética, Médica y Quirúrgica 2025; 23 (3)

Follicular mucinosis: a review of the literature

Rodríguez RX, Santiago BMJ, Vega MME

Language: Spanish
References: 56
Page: 245-253
PDF size: 283.02 Kb.


ABSTRACT

Follicular mucinosis is a rare condition marked by the infiltration of the outer root sheath of hair follicles and sebaceous glands. This infiltration leads to a reticular degeneration pattern filled with acidic mucopolysaccharide deposits. It’s categorized into primary and secondary forms. The primary form is a diagnosis of exclusion, while the secondary form is typically linked to an underlying disorder, most notably lymphoproliferative hematologic malignancies like cutaneous T-cell lymphomas (e.g., mycosis fungoides and Sézary syndrome). Therefore, achieving a definitive diagnosis is crucial, though differentiating between these patterns can be complex in clinical practice. The exact cause of follicular mucinosis remains unknown, but the involvement of immune complexes and cellular immunity has been suggested. It’s thought that lymphokines from T-helper lymphocytes might stimulate follicular keratinocytes, leading to mucin production. Dermoscopy has revealed proposed patterns, such as the “toothpaste sign”. A histopathological study is essential for diagnosis and to rule out other conditions. Due to its low frequency, there are currently no standardized treatment guidelines; most recommendations come from clinical case reports or series. Various treatments, including minocycline, isotretinoin, phototherapy, dapsone, and topical corticosteroids, have been reported with varying outcomes and durations of use.


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