chondroitin-sulfates and Mucinoses

46-year-old woman developed painful ulcers over her lower abdomen in the form of reticulate erythema after injecting interferon beta-1b subcutaneously for multiple sclerosis. Skin biopsy revealed multiple superficial thrombosed vessels with focal epidermal necrosis as well as prominent interstitial mucinosis. Treatment with low-molecular-weight heparin followed by a heparinoid resulted in slow healing of the ulcers but also allowed the subcutaneous interferon injections to be continued.

Topics: Abdominal Wall; Adjuvants, Immunologic; Chondroitin Sulfates; Dermatan Sulfate; Enoxaparin; Female; Fibrinolytic Agents; Heparitin Sulfate; Humans; Injections, Subcutaneous; Interferon beta-1b; Interferon-beta; Middle Aged; Mucinoses; Multiple Sclerosis; Thrombosis; Treatment Outcome; Ulcer

We report a patient with the typical lesions of diabetic scleredema. Histological findings of the involved skin were thickening of the dermis, depositions of mucins, and fibrosis. Biochemical analysis revealed an increase in glycosaminoglycans in the involved skin as well as in the cutaneous lupus mucinosis. Mucinous materials were composed of hyaluronic acid.

Topics: Chondroitin Sulfates; Dermatan Sulfate; Diabetes Complications; Female; Fibrosis; Glycosaminoglycans; Humans; Hyaluronic Acid; Middle Aged; Mucinoses; Mucins; Scleredema Adultorum; Skin

The mechanism for the production of papulonodular mucinosis in patients with lupus erythematosus (LE) is not known.. Our purpose was to determine whether fibroblasts in a patient with LE and papulonodular mucinosis produced more mucin than normal fibroblasts and whether this mucin production could be stimulated by the patient's serum.. Skin fibroblasts from a patient with systemic LE and massive papulonodular mucin deposition, as well as normal fibroblasts, were incubated in the presence of serum from the patient or from a healthy volunteer. The production of glycosaminoglycan by fibroblasts was analyzed.. Fibroblasts from the patient produced more glycosaminoglycan than did normal fibroblasts. Glycosaminoglycan production was increased in all cells when incubated in the presence of the patient's serum.. Cutaneous mucin deposition in patients with papulonodular LE skin lesions is associated with increased glycosaminoglycan production by dermal fibroblasts. Our preliminary observations suggest glycosaminoglycan production by these fibroblasts appears to be stimulated by a factor, (or factors) in the patient's serum that is yet to be identified.

Topics: Adult; Cells, Cultured; Chondroitin Sulfates; Fibroblasts; Glycosaminoglycans; Heparitin Sulfate; Humans; Hyaluronic Acid; Keratinocytes; Lupus Erythematosus, Systemic; Male; Mucinoses; Mucins; Skin; Up-Regulation