Clinical features and efficacy of antimalarial treatment for reticular erythematous mucinosis: a case series of 11 patients.

Abstract

BACKGROUND:

Reticular erythematous mucinosis (REM syndrome) is a rare cutaneous disease that predominantly affects the chest and upper back area of middle-aged women. Although antimalarial treatment is generally considered the most effective approach, only a few case reports exist on its use in REM syndrome.

OBSERVATIONS:

A total of 11 patients with REM syndrome (10 women and 1 man), mean age, 44 years (age range, 37-54 years), were included in this retrospective analysis. Ten of the 11 patients were cigarette smokers (91%), and 6 had concomitant autoimmune diseases (55%). Since no clinical score exists for REM syndrome, we used the validated Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) to evaluate the efficacy of antimalarial treatment. Overall, a significant decrease in the clinical score was observed from a median of 4 (range, 2-8) before initiation of treatment to 0 (range, 0-4) after 3 months of antimalarial therapy and to 0 (range, 0-4) after 12 months of therapy (P < .001). Two patients withdrew from the study owing to adverse gastrointestinal tract effects (nausea and vomiting); 2 relapsed after finishing their antimalarial regimens; 3 patients were free of disease 2 years after the end of treatment; and 4 patients were lost to follow-up.

CONCLUSION:

Antimalarial agents significantly improve or completely clear the skin lesions of patients with REM syndrome and should be considered as a first-line therapy for this rare disease.

• Authors: Alexander Kreuter, Nina Scola, Christian Tigges, Peter Altmeyer, Thilo Gambichler
• Journal: Archives of dermatology (Arch Dermatol) Vol. 147 Issue 6 Pg. 710-5 (Jun 2011) ISSN: 1538-3652 [Electronic] United States
• PMID: 21339419 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antimalarials
• Steroids
• Chloroquine

Topics

• Adult
• Antimalarials (adverse effects, therapeutic use)
• Chloroquine (adverse effects, therapeutic use)
• Comorbidity
• Erythema (drug therapy, epidemiology, pathology)
• Female
• Humans
• Male
• Middle Aged
• Mucinoses (drug therapy, epidemiology, pathology)
• Retrospective Studies
• Smoking (epidemiology)
• Steroids (therapeutic use)