Reticular erythematous mucinosis: a review of patients' characteristics, associated conditions, therapy and outcome in 25 cases
Identifieur interne : 000128 ( Istex/Corpus ); précédent : 000127; suivant : 000129Reticular erythematous mucinosis: a review of patients' characteristics, associated conditions, therapy and outcome in 25 cases
Auteurs : F. Rongioletti ; V. Merlo ; S. Riva ; E. Cozzani ; E. Cinotti ; G. Ghigliotti ; A. Parodi ; J. KanitakisSource :
- British Journal of Dermatology [ 0007-0963 ] ; 2013-12.
English descriptors
- Teeft :
- Antimalarial, Arch dermatol, British association, British journal, Carcinoma, Complete remission, Contraceptive, Contraceptive pill, Cutaneous, Cutaneous lupus erythematosus, Dermatol, Dermatology, Dermoepidermal junction, Erythematosus, Erythematous, Erythematous macules, Histopathological, Lesion, Lupus, Lupus erythematosus, Mucin, Mucinosis, Neck chest, Other conditions, Possible association, Recognizable disease, Reticular, Reticular erythematous mucinosis, Reticular pattern, Reticulated patterns, Rongioletti, Skin lesions, Thyroid dysfunctions, Upper abdomen.
Abstract
Background: Reticular erythematous mucinosis (REM) is an uncommon disease, the nosology and specific characteristics of which are controversial because most reports deal with single cases or small series. Objectives: To describe the characteristics of patients with REM regarding demographics, clinical and pathological features, comorbidities, treatment and course. Methods: A retrospective and prospective study was conducted on 25 patients diagnosed with REM in the setting of university‐affiliated dermatology departments and dermatopathology centres. Results: Of the 25 patients with REM, 16 were women (sex ratio 2 : 1) and the mean age was 46 years. The roles of sun exposure and oral contraceptives were ambiguous. Associated diseases included hypertension (n = 4), malignancies (n = 3), autoimmune diseases (n = 3) and Borrelia infection (n = 1). Immunological studies (including serology and direct immunofluorescence) were noncontributory. The response to antimalarial treatment was good in > 80% of cases. Worsening or recurrence of the lesion after treatment discontinuation, or in the course of the disease, occurred in 31% of patients. Conclusions: We present the largest REM case series to date. The reticular pattern with involvement of the midline of the chest and back, the predilection for middle‐aged women, the controversial relationship with photosensitivity and the possible association with other conditions such as malignancies and thyroid dysfunctions are the main characteristics that makes REM a recognizable disease.
What's already known about this topic? Reticular erythematous mucinosis (REM) is an uncommon disease, the nosology and specific characteristics of which are controversial because most reports deal with single cases or small series. What does this study add? We report one of the largest case series of REM to date. We highlight the reticular pattern in REM; the predilection for middle‐aged women; the ambiguous role of photosensitivity; the possible association with other conditions such as malignancies and thyroid dysfunctions; and the good response to antimalarials, with possible relapses. Together, these factors make REM a recognizable disease.
Url:
DOI: 10.1111/bjd.12577
Links to Exploration step
ISTEX:1CDDEB60FCB204EA05927C12B442160C9B4CCF3BLe document en format XML
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Merlo</name><affiliation><mods:affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</mods:affiliation></affiliation></author><author><name sortKey="Riva, S" sort="Riva, S" uniqKey="Riva S" first="S." last="Riva">S. Riva</name><affiliation><mods:affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</mods:affiliation></affiliation></author><author><name sortKey="Cozzani, E" sort="Cozzani, E" uniqKey="Cozzani E" first="E." last="Cozzani">E. Cozzani</name><affiliation><mods:affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</mods:affiliation></affiliation></author><author><name sortKey="Cinotti, E" sort="Cinotti, E" uniqKey="Cinotti E" first="E." last="Cinotti">E. Cinotti</name><affiliation><mods:affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</mods:affiliation></affiliation></author><author><name sortKey="Ghigliotti, G" sort="Ghigliotti, G" uniqKey="Ghigliotti G" first="G." last="Ghigliotti">G. Ghigliotti</name><affiliation><mods:affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</mods:affiliation></affiliation></author><author><name sortKey="Parodi, A" sort="Parodi, A" uniqKey="Parodi A" first="A." last="Parodi">A. Parodi</name><affiliation><mods:affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</mods:affiliation></affiliation></author><author><name sortKey="Kanitakis, J" sort="Kanitakis, J" uniqKey="Kanitakis J" first="J." last="Kanitakis">J. 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Rongioletti</name><affiliation><mods:affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>.:</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: franco.rongioletti@unige.it</mods:affiliation></affiliation></author><author><name sortKey="Merlo, V" sort="Merlo, V" uniqKey="Merlo V" first="V." last="Merlo">V. Merlo</name><affiliation><mods:affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</mods:affiliation></affiliation></author><author><name sortKey="Riva, S" sort="Riva, S" uniqKey="Riva S" first="S." last="Riva">S. Riva</name><affiliation><mods:affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</mods:affiliation></affiliation></author><author><name sortKey="Cozzani, E" sort="Cozzani, E" uniqKey="Cozzani E" first="E." last="Cozzani">E. Cozzani</name><affiliation><mods:affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</mods:affiliation></affiliation></author><author><name sortKey="Cinotti, E" sort="Cinotti, E" uniqKey="Cinotti E" first="E." last="Cinotti">E. Cinotti</name><affiliation><mods:affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</mods:affiliation></affiliation></author><author><name sortKey="Ghigliotti, G" sort="Ghigliotti, G" uniqKey="Ghigliotti G" first="G." last="Ghigliotti">G. 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Herriot Hospital Group, 5 Place d'Arsonval, 69437, Lyon, France</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">British Journal of Dermatology</title><title level="j" type="alt">BRITISH JOURNAL OF DERMATOLOGY</title><idno type="ISSN">0007-0963</idno><idno type="eISSN">1365-2133</idno><imprint><biblScope unit="vol">169</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1207">1207</biblScope><biblScope unit="page" to="1211">1211</biblScope><biblScope unit="page-count">5</biblScope><date type="published" when="2013-12">2013-12</date></imprint><idno type="ISSN">0007-0963</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0007-0963</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Antimalarial</term><term>Arch dermatol</term><term>British association</term><term>British journal</term><term>Carcinoma</term><term>Complete remission</term><term>Contraceptive</term><term>Contraceptive pill</term><term>Cutaneous</term><term>Cutaneous lupus erythematosus</term><term>Dermatol</term><term>Dermatology</term><term>Dermoepidermal junction</term><term>Erythematosus</term><term>Erythematous</term><term>Erythematous macules</term><term>Histopathological</term><term>Lesion</term><term>Lupus</term><term>Lupus erythematosus</term><term>Mucin</term><term>Mucinosis</term><term>Neck chest</term><term>Other conditions</term><term>Possible association</term><term>Recognizable disease</term><term>Reticular</term><term>Reticular erythematous mucinosis</term><term>Reticular pattern</term><term>Reticulated patterns</term><term>Rongioletti</term><term>Skin lesions</term><term>Thyroid dysfunctions</term><term>Upper abdomen</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract">Background: Reticular erythematous mucinosis (REM) is an uncommon disease, the nosology and specific characteristics of which are controversial because most reports deal with single cases or small series. Objectives: To describe the characteristics of patients with REM regarding demographics, clinical and pathological features, comorbidities, treatment and course. Methods: A retrospective and prospective study was conducted on 25 patients diagnosed with REM in the setting of university‐affiliated dermatology departments and dermatopathology centres. Results: Of the 25 patients with REM, 16 were women (sex ratio 2 : 1) and the mean age was 46 years. The roles of sun exposure and oral contraceptives were ambiguous. Associated diseases included hypertension (n = 4), malignancies (n = 3), autoimmune diseases (n = 3) and Borrelia infection (n = 1). Immunological studies (including serology and direct immunofluorescence) were noncontributory. The response to antimalarial treatment was good in > 80% of cases. Worsening or recurrence of the lesion after treatment discontinuation, or in the course of the disease, occurred in 31% of patients. Conclusions: We present the largest REM case series to date. The reticular pattern with involvement of the midline of the chest and back, the predilection for middle‐aged women, the controversial relationship with photosensitivity and the possible association with other conditions such as malignancies and thyroid dysfunctions are the main characteristics that makes REM a recognizable disease.</div><div type="abstract" xml:lang="en">What's already known about this topic? Reticular erythematous mucinosis (REM) is an uncommon disease, the nosology and specific characteristics of which are controversial because most reports deal with single cases or small series. What does this study add? We report one of the largest case series of REM to date. We highlight the reticular pattern in REM; the predilection for middle‐aged women; the ambiguous role of photosensitivity; the possible association with other conditions such as malignancies and thyroid dysfunctions; and the good response to antimalarials, with possible relapses. 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Rongioletti et al.</json:string><json:string>Steigleder et al.</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/WNG-PN597WBJ-3</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - dermatology</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - clinical medicine</json:string><json:string>3 - dermatology & venereal diseases</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Dermatology</json:string></scopus><inist><json:string>1 - sciences appliquees, technologies et medecines</json:string><json:string>2 - sciences biologiques et medicales</json:string><json:string>3 - sciences medicales</json:string></inist></categories><publicationDate>2013</publicationDate><copyrightDate>2013</copyrightDate><doi><json:string>10.1111/bjd.12577</json:string></doi><id>1CDDEB60FCB204EA05927C12B442160C9B4CCF3B</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-PN597WBJ-3/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-PN597WBJ-3/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/WNG-PN597WBJ-3/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">Reticular erythematous mucinosis: a review of patients' characteristics, associated conditions, therapy and outcome in 25 cases</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher ref="https://scientific-publisher.data.istex.fr/ark:/67375/H02-QW5Q88H5-V">Wiley Publishing Ltd</publisher><availability><licence>© 2013 British Association of Dermatologists</licence></availability><date type="published" when="2013-12"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">Reticular erythematous mucinosis: a review of patients' characteristics, associated conditions, therapy and outcome in 25 cases</title><author xml:id="author-0000" role="corresp"><persName><forename type="first">F.</forename><surname>Rongioletti</surname></persName><affiliation><orgName type="division">Section of Dermatology</orgName>
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<country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><idno type="istex">1CDDEB60FCB204EA05927C12B442160C9B4CCF3B</idno><idno type="ark">ark:/67375/WNG-PN597WBJ-3</idno><idno type="DOI">10.1111/bjd.12577</idno><idno type="unit">BJD12577</idno><idno type="toTypesetVersion">file:BJD.BJD12577.pdf</idno></analytic><monogr><title level="j" type="main">British Journal of Dermatology</title><title level="j" type="alt">BRITISH JOURNAL OF DERMATOLOGY</title><idno type="pISSN">0007-0963</idno><idno type="eISSN">1365-2133</idno><idno type="book-DOI">10.1111/(ISSN)1365-2133</idno><idno type="book-part-DOI">10.1111/bjd.2013.169.issue-6</idno><idno type="product">BJD</idno><imprint><biblScope unit="vol">169</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1207">1207</biblScope><biblScope unit="page" to="1211">1211</biblScope><biblScope unit="page-count">5</biblScope><date type="published" when="2013-12"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><encodingDesc><schemaRef type="ODD" url="https://xml-schema.delivery.istex.fr/tei-istex.odd"></schemaRef><appInfo><application ident="pub2tei" version="1.0.10" when="2019-12-20"><label>pub2TEI-ISTEX</label><desc>A set of style sheets for converting XML documents encoded in various scientific publisher formats into a common TEI format.
<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><profileDesc><abstract style="main" xml:id="bjd12577-abs-0001"><head>Summary</head><head>Background</head><p>Reticular erythematous mucinosis (<hi rend="fc">REM</hi>) is an uncommon disease, the nosology and specific characteristics of which are controversial because most reports deal with single cases or small series.</p><head>Objectives</head><p>To describe the characteristics of patients with <hi rend="fc">REM</hi> regarding demographics, clinical and pathological features, comorbidities, treatment and course.</p><head>Methods</head><p>A retrospective and prospective study was conducted on 25 patients diagnosed with <hi rend="fc">REM</hi> in the setting of university‐affiliated dermatology departments and dermatopathology centres.</p><head>Results</head><p>Of the 25 patients with <hi rend="fc">REM</hi>, 16 were women (sex ratio 2 : 1) and the mean age was 46 years. The roles of sun exposure and oral contraceptives were ambiguous. Associated diseases included hypertension (<hi rend="italic">n </hi>=<hi rend="italic"> </hi>4), malignancies (<hi rend="italic">n </hi>=<hi rend="italic"> </hi>3), autoimmune diseases (<hi rend="italic">n </hi>=<hi rend="italic"> </hi>3) and <hi rend="italic">Borrelia</hi> infection (<hi rend="italic">n </hi>=<hi rend="italic"> </hi>1). Immunological studies (including serology and direct immunofluorescence) were noncontributory. The response to antimalarial treatment was good in > 80% of cases. Worsening or recurrence of the lesion after treatment discontinuation, or in the course of the disease, occurred in 31% of patients.</p><head>Conclusions</head><p>We present the largest <hi rend="fc">REM</hi> case series to date. The reticular pattern with involvement of the midline of the chest and back, the predilection for middle‐aged women, the controversial relationship with photosensitivity and the possible association with other conditions such as malignancies and thyroid dysfunctions are the main characteristics that makes <hi rend="fc">REM</hi> a recognizable disease.</p></abstract><abstract xml:lang="en" style="short" xml:id="bjd12577-abs-0002"><p><hi rend="bold">What's already known about this topic?</hi></p><p><list xml:id="bjd12577-list-0001" style="bulleted"><item>Reticular erythematous mucinosis (REM) is an uncommon disease, the nosology and specific characteristics of which are controversial because most reports deal with single cases or small series.</item></list></p><p><hi rend="bold">What does this study add?</hi></p><p><list xml:id="bjd12577-list-0002" style="bulleted"><item>We report one of the largest case series of REM to date.</item><item>We highlight the reticular pattern in REM; the predilection for middle‐aged women; the ambiguous role of photosensitivity; the possible association with other conditions such as malignancies and thyroid dysfunctions; and the good response to antimalarials, with possible relapses.</item><item>Together, these factors make REM a recognizable disease.</item></list></p></abstract><textClass><keywords rend="articleCategory"><term>Clinical and Laboratory Investigations</term></keywords><keywords rend="tocHeading1"><term>Original articles</term></keywords><keywords rend="tocHeading2"><term>Clinical and laboratory investigations</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc><revisionDesc><change when="2019-12-20" who="#istex" xml:id="pub2tei">formatting</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-PN597WBJ-3/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component type="serialArticle" version="2.0" xml:id="bjd12577" xml:lang="en"><header><publicationMeta level="product"><doi origin="wiley" registered="yes">10.1111/(ISSN)1365-2133</doi><issn type="print">0007-0963</issn><issn type="electronic">1365-2133</issn><idGroup><id type="product" value="BJD"></id></idGroup><titleGroup><title sort="BRITISH JOURNAL OF DERMATOLOGY" type="main">British Journal of Dermatology</title><title type="short">Br J Dermatol</title></titleGroup></publicationMeta><publicationMeta level="part" position="12106"><doi origin="wiley">10.1111/bjd.2013.169.issue-6</doi><copyright ownership="thirdParty">BJD © 2013 British Association of Dermatologists</copyright><numberingGroup><numbering number="169" type="journalVolume">169</numbering><numbering type="journalIssue">6</numbering></numberingGroup><coverDate startDate="2013-12">December 2013</coverDate></publicationMeta><publicationMeta level="unit" position="110" status="forIssue" type="article"><doi>10.1111/bjd.12577</doi><idGroup><id type="unit" value="BJD12577"></id></idGroup><countGroup><count number="5" type="pageTotal"></count></countGroup><titleGroup><title type="articleCategory">Clinical and Laboratory Investigations</title><title type="tocHeading1">Original articles</title><title type="tocHeading2">Clinical and laboratory investigations</title></titleGroup><copyright ownership="thirdParty">© 2013 British Association of Dermatologists</copyright><eventGroup><event date="2013-08-01" type="manuscriptAccepted"></event><event agent="SPS" date="2013-10-10" type="xmlCreated"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.2.9 mode:FullText" date="2014-02-04"></event><event type="publishedOnlineAccepted" date="2013-08-12"></event><event type="publishedOnlineFinalForm" date="2013-12-02"></event><event type="firstOnline" date="2013-12-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.6.4 mode:FullText" date="2015-10-02"></event></eventGroup><numberingGroup><numbering type="pageFirst">1207</numbering><numbering type="pageLast">1211</numbering></numberingGroup><correspondenceTo><lineatedText><line><b>Correspondence</b></line><line><i>Franco Rongioletti</i>.</line><line><i>E‐mail</i>: <email>franco.rongioletti@unige.it</email></line></lineatedText></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:BJD.BJD12577.pdf"></link></linkGroup></publicationMeta><contentMeta><titleGroup><title type="main">Reticular erythematous mucinosis: a review of patients' characteristics, associated conditions, therapy and outcome in 25 cases</title><title type="shortAuthors">F. Rongioletti <i>et al</i>.</title></titleGroup><creators><creator affiliationRef="#bjd12577-aff-0001" corresponding="yes" creatorRole="author" xml:id="bjd12577-cr-0001"><personName><givenNames>F.</givenNames> <familyName>Rongioletti</familyName></personName></creator><creator affiliationRef="#bjd12577-aff-0001" creatorRole="author" xml:id="bjd12577-cr-0002"><personName><givenNames>V.</givenNames> <familyName>Merlo</familyName></personName></creator><creator affiliationRef="#bjd12577-aff-0001" creatorRole="author" xml:id="bjd12577-cr-0003"><personName><givenNames>S.</givenNames> <familyName>Riva</familyName></personName></creator><creator affiliationRef="#bjd12577-aff-0001" creatorRole="author" xml:id="bjd12577-cr-0004"><personName><givenNames>E.</givenNames> <familyName>Cozzani</familyName></personName></creator><creator affiliationRef="#bjd12577-aff-0001" creatorRole="author" xml:id="bjd12577-cr-0005"><personName><givenNames>E.</givenNames> <familyName>Cinotti</familyName></personName></creator><creator affiliationRef="#bjd12577-aff-0001" creatorRole="author" xml:id="bjd12577-cr-0006"><personName><givenNames>G.</givenNames> <familyName>Ghigliotti</familyName></personName></creator><creator affiliationRef="#bjd12577-aff-0001" creatorRole="author" xml:id="bjd12577-cr-0007"><personName><givenNames>A.</givenNames> <familyName>Parodi</familyName></personName></creator><creator affiliationRef="#bjd12577-aff-0002" creatorRole="author" xml:id="bjd12577-cr-0008"><personName><givenNames>J.</givenNames> <familyName>Kanitakis</familyName></personName></creator></creators><affiliationGroup><affiliation countryCode="IT" type="organization" xml:id="bjd12577-aff-0001"><orgDiv>Section of Dermatology</orgDiv> <orgDiv>Department of Health Sciences (DISSAL)</orgDiv> <orgName>University of Genoa</orgName> <address><street>Viale Benedetto XV</street> <postCode>16132</postCode> <city>Genoa</city> <country>Italy</country></address></affiliation><affiliation countryCode="FR" type="organization" xml:id="bjd12577-aff-0002"><orgDiv>Department of Dermatology</orgDiv> <orgName>Ed. Herriot Hospital Group</orgName> <address><street>5 Place d'Arsonval</street> <postCode>69437</postCode> <city>Lyon</city> <country>France</country></address></affiliation></affiliationGroup><abstractGroup><abstract type="main" xml:id="bjd12577-abs-0001"><title type="main">Summary</title><section xml:id="bjd12577-sec-0001"><title type="main">Background</title><p>Reticular erythematous mucinosis (<fc>REM</fc>) is an uncommon disease, the nosology and specific characteristics of which are controversial because most reports deal with single cases or small series.</p></section><section xml:id="bjd12577-sec-0002"><title type="main">Objectives</title><p>To describe the characteristics of patients with <fc>REM</fc> regarding demographics, clinical and pathological features, comorbidities, treatment and course.</p></section><section xml:id="bjd12577-sec-0003"><title type="main">Methods</title><p>A retrospective and prospective study was conducted on 25 patients diagnosed with <fc>REM</fc> in the setting of university‐affiliated dermatology departments and dermatopathology centres.</p></section><section xml:id="bjd12577-sec-0004"><title type="main">Results</title><p>Of the 25 patients with <fc>REM</fc>, 16 were women (sex ratio 2 : 1) and the mean age was 46 years. The roles of sun exposure and oral contraceptives were ambiguous. Associated diseases included hypertension (<i>n </i>=<i> </i>4), malignancies (<i>n </i>=<i> </i>3), autoimmune diseases (<i>n </i>=<i> </i>3) and <i>Borrelia</i> infection (<i>n </i>=<i> </i>1). Immunological studies (including serology and direct immunofluorescence) were noncontributory. The response to antimalarial treatment was good in > 80% of cases. Worsening or recurrence of the lesion after treatment discontinuation, or in the course of the disease, occurred in 31% of patients.</p></section><section xml:id="bjd12577-sec-0005"><title type="main">Conclusions</title><p>We present the largest <fc>REM</fc> case series to date. The reticular pattern with involvement of the midline of the chest and back, the predilection for middle‐aged women, the controversial relationship with photosensitivity and the possible association with other conditions such as malignancies and thyroid dysfunctions are the main characteristics that makes <fc>REM</fc> a recognizable disease.</p></section></abstract><abstract type="short" xml:id="bjd12577-abs-0002" xml:lang="en"><p><b>What's already known about this topic?</b></p><p><list formatted="paragraph" style="bulleted" xml:id="bjd12577-list-0001"><listItem>Reticular erythematous mucinosis (REM) is an uncommon disease, the nosology and specific characteristics of which are controversial because most reports deal with single cases or small series.</listItem></list></p><p><b>What does this study add?</b></p><p><list formatted="paragraph" style="bulleted" xml:id="bjd12577-list-0002"><listItem>We report one of the largest case series of REM to date.</listItem><listItem>We highlight the reticular pattern in REM; the predilection for middle‐aged women; the ambiguous role of photosensitivity; the possible association with other conditions such as malignancies and thyroid dysfunctions; and the good response to antimalarials, with possible relapses.</listItem><listItem>Together, these factors make REM a recognizable disease.</listItem></list></p></abstract></abstractGroup></contentMeta><noteGroup xml:id="bjd12577-ntgp-0001"><note numbered="no" xml:id="bjd12577-note-0001"><b>Funding sources</b> None.</note><note numbered="no" xml:id="bjd12577-note-0002"><b>Conflicts of interest</b> None declared.</note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Reticular erythematous mucinosis: a review of patients' characteristics, associated conditions, therapy and outcome in 25 cases</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Reticular erythematous mucinosis: a review of patients' characteristics, associated conditions, therapy and outcome in 25 cases</title></titleInfo><name type="personal"><namePart type="given">F.</namePart><namePart type="family">Rongioletti</namePart><affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</affiliation><affiliation>.:</affiliation><affiliation>E-mail: franco.rongioletti@unige.it</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">V.</namePart><namePart type="family">Merlo</namePart><affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S.</namePart><namePart type="family">Riva</namePart><affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">E.</namePart><namePart type="family">Cozzani</namePart><affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">E.</namePart><namePart type="family">Cinotti</namePart><affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">G.</namePart><namePart type="family">Ghigliotti</namePart><affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A.</namePart><namePart type="family">Parodi</namePart><affiliation>Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.</namePart><namePart type="family">Kanitakis</namePart><affiliation>Department of Dermatology, Ed. Herriot Hospital Group, 5 Place d'Arsonval, 69437, Lyon, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><dateIssued encoding="w3cdtf">2013-12</dateIssued><dateCreated encoding="w3cdtf">2013-10-10</dateCreated><dateValid encoding="w3cdtf">2013-08-01</dateValid><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract>Background: Reticular erythematous mucinosis (REM) is an uncommon disease, the nosology and specific characteristics of which are controversial because most reports deal with single cases or small series. Objectives: To describe the characteristics of patients with REM regarding demographics, clinical and pathological features, comorbidities, treatment and course. Methods: A retrospective and prospective study was conducted on 25 patients diagnosed with REM in the setting of university‐affiliated dermatology departments and dermatopathology centres. Results: Of the 25 patients with REM, 16 were women (sex ratio 2 : 1) and the mean age was 46 years. The roles of sun exposure and oral contraceptives were ambiguous. Associated diseases included hypertension (n = 4), malignancies (n = 3), autoimmune diseases (n = 3) and Borrelia infection (n = 1). Immunological studies (including serology and direct immunofluorescence) were noncontributory. The response to antimalarial treatment was good in > 80% of cases. Worsening or recurrence of the lesion after treatment discontinuation, or in the course of the disease, occurred in 31% of patients. Conclusions: We present the largest REM case series to date. The reticular pattern with involvement of the midline of the chest and back, the predilection for middle‐aged women, the controversial relationship with photosensitivity and the possible association with other conditions such as malignancies and thyroid dysfunctions are the main characteristics that makes REM a recognizable disease.</abstract><abstract type="short" lang="en">What's already known about this topic? Reticular erythematous mucinosis (REM) is an uncommon disease, the nosology and specific characteristics of which are controversial because most reports deal with single cases or small series. What does this study add? We report one of the largest case series of REM to date. We highlight the reticular pattern in REM; the predilection for middle‐aged women; the ambiguous role of photosensitivity; the possible association with other conditions such as malignancies and thyroid dysfunctions; and the good response to antimalarials, with possible relapses. Together, these factors make REM a recognizable disease.</abstract><relatedItem type="host"><titleInfo><title>British Journal of Dermatology</title></titleInfo><titleInfo type="abbreviated"><title>Br J Dermatol</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><subject><genre>article-category</genre><topic>Clinical and Laboratory Investigations</topic><topic>Original articles</topic><topic>Clinical and laboratory investigations</topic></subject><identifier type="ISSN">0007-0963</identifier><identifier type="eISSN">1365-2133</identifier><identifier type="DOI">10.1111/(ISSN)1365-2133</identifier><identifier type="PublisherID">BJD</identifier><part><date>2013</date><detail type="volume"><caption>vol.</caption><number>169</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>1207</start><end>1211</end><total>5</total></extent></part></relatedItem><relatedItem type="references" displayLabel="bjd12577-cit-0001"><titleInfo><title>REM syndrome: reticular erythematous mucinosis (round‐cell erythematosis), a new entity?</title></titleInfo><name type="personal"><namePart type="given">GK</namePart><namePart type="family">Steigleder</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">H</namePart><namePart type="family">Gartmann</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">U</namePart><namePart type="family">Linker</namePart><role><roleTerm type="text">author</roleTerm></role></name><genre>journal-article</genre><note type="citation/reference">Steigleder GK, Gartmann H, Linker U. 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