Mucinosis follicularis is a disease of the skin in which the follicles of the hair harden. Mucinosis follicularis is also known by the synonyms pinkus alopecia or alopecia mucinosa. The hair follicles can be felt with the fingers. In common parlance, mucinosis follicularis is also known as friction skin.
What is mucinosis follicularis?
Mucinosis follicularis is also known as scorbutic goose bumps by some medical professionals. The disease is either symptomatic or idiopathic in nature. Characteristic of mucinosis follicularis are deposits of mucin inside the sebaceous glands of the skin. The deposits occur in the intraepithelial area and in the majority of cases also affect the walls of the hair follicles. As mucinosis follicularis progresses, affected individuals experience alopecia associated with scarring of the diseased areas of the skin. Within Europe, rubbing iron skin occurs comparatively often. The first describer of mucinosis follicularis was Kreibich, who described the disease scientifically in 1904.
Causes
Not everything is yet known about the exact background of the development of mucinosis follicularis. However, numerous researchers and physicians suspect that the disease genesis is related to damage to the cells. As a result of this damage, certain mucoid substances are formed in the system of the sebaceous gland as well as the sheaths of the hair roots. These substances are subsequently deposited. Histological analyses of hair follicles reveal corresponding abnormalities that indicate degeneration.
Symptoms, complaints and signs
Basically, doctors differentiate into two different types of mucinosis follicularis: the first form is an acute manifestation of the disease. In this case, mucinosis follicularis occurs acutely in the subcutaneous area and is benign. The skin of affected patients shows the typical foci filled with doughy substances. In addition, the areas show alopecia. The second type of mucinosis follicularis is a manifestation with a chronic course. In this case, it is also a benign disease. The foci are usually keratotic and have different shapes. In the majority of cases, the papules of this form of mucinosis follicularis appear on the limbs of the affected individuals. The trunk may also be affected by the disease. In addition, mucinosis follicularis occurs in some cases in connection with malignant lymphomas. In these cases, there is also a chronic course of mucinosis follicularis. Here, the symptoms are more similar to those of a specific mycosis fungoides, which mainly affects the follicles of the hair. In principle, mucinosis follicularis is a so-called paraneoplasia. Mucinosis follicularis is basically characterized by often itchy foci. In the diseased areas, the existing hairs are lost. In addition, typical papules with clear demarcation from the surrounding skin appear in numerous cases. The foci are slightly raised and usually show a more or less intense redness. In the majority of cases, the disease appears on the cranial side of the body.
Diagnosis and course of the disease
A large number of people observe symptoms of rubbing iron skin or mucinosis follicularis in themselves and consult a dermatologist with the corresponding symptoms at best. The diagnosis of mucinosis follicularis uses different techniques. In the course of the diagnosis of mucinosis follicularis, various histopathological laboratory analyses are usually used. In the majority of cases, degeneration of cells is found. Such changes primarily affect the outer sheaths of the hair roots as well as the sebaceous glands. Cystic intermediate areas containing mucin are found at the foci. The nature of the deposits may indicate the underlying disease of mucinosis follicularis. The treating physician has to consider various diseases in the differential diagnosis. For example, he must rule out tinea barbae, tinea capitis, and lichen ruber planus. In addition, mucinosis follicularis must be differentiated from lichen simplex chronicus, alopecia areata and seborrheic eczema.
Complications
Due to mucinosis follicularis, affected individuals primarily suffer from various skin complaints. These can thereby significantly limit and reduce the quality of life. Likewise, the daily life of the affected person is significantly complicated and it is not uncommon for psychological discomfort or even depression to occur. Sometimes the itching can also negatively affect the patient’s sleep, resulting in sleep problems and thus irritability of the patient. It is not uncommon for those affected to feel ashamed of the skin complaints and thus also suffer from inferiority complexes or reduced self-esteem. Especially on the extremities the complaints can be very unpleasant, so that most patients are ashamed of them. Usually, mucinosis follicularis can be cured with the help of medication. Likewise, radiation therapy is often used to accelerate healing. Complications usually do not occur. However, the underlying disease responsible for mucinosis follicularis must also be treated. It is not possible to predict a general course of the disease. However, the patient’s life expectancy is usually not affected by mucinosis follicularis.
When should you see a doctor?
If the affected person notices sudden changes in the appearance of the skin, they should be presented to a physician. If the symptoms spread or increase in intensity, a visit to the doctor is strongly advised to avoid further illness. Hardening, discoloration or skin blemishes should be examined and treated. By examining the skin, a diagnosis can be made, which also provides information about the further course of the disease. Since there are diseases with a fatal course, a visit to the doctor should be made as early as possible at the first peculiarities of the skin appearance. In addition, an annual check-up with a doctor is recommended. This serves the early detection of possible skin diseases and is especially recommended to people in adulthood or people with a susceptible skin. The development of poplars is considered unusual and must be investigated. If swelling, itching or open wounds occur, a visit to the doctor is recommended. Sterile wound care is necessary to prevent germs from entering the organism or causing blood poisoning. Pain on the skin, sensitivity to light, temperature or touch as well as sensory disturbances must be presented to a doctor. If there is numbness or hypersensitivity, there is a disorder that needs medical attention. If, in addition, emotional discomfort, anxiety or behavioral abnormalities occur, consultation with a physician should also take place.
Treatment and therapy
Current options for treatment of mucinosis follicularis are limited. In the majority of cases, therapy for mucinosis follicularis shows little clear success. Possibilities include glucocorticoids or dapsone. In addition, some patients with mucinosis follicularis receive so-called soft X-ray therapy. When treating the symptoms of mucinosis follicularis, the underlying disease must always be considered and treated. The prognosis of mucinosis follicularis varies widely. In some cases, the foci on the skin regress spontaneously. In other patients, the symptoms extend to the entire surface of the skin. However, the course of mucinosis follicularis is essentially related to the individual causes of each type of the disease. In the acute and idiopathic type of mucinosis follicularis, healing results after several weeks or months. In chronic mucinosis follicularis, there is virtually no regression of disease symptoms.
Outlook and prognosis
In the disease mucinosis follicularis, patients mainly suffer from various skin complaints. These skin complaints can particularly limit and even reduce the quality of life. The patients’ daily life is also made very difficult by the disease. In addition, it is not uncommon for psychological complaints and even severe depression to occur. Among other things, the constant itching can also negatively affect the sleep of those affected, so that the patients have severe sleep complaints, which lead to the irritability of the patients.In many cases, patients are ashamed of their skin complaints and therefore also often suffer from reduced self-esteem and even inferiority complexes. Especially on the extremities, the symptoms are extremely unpleasant and often visible to others, which is why most sufferers are ashamed of them. As a rule, the disease mucinosis follicularis can be improved and cured with the help of medication. Special radiation therapy is often used to accelerate the healing process. Severe complications of the disease are usually rare. However, the underlying disease, which is the trigger for the disease mucinosis follicularis, must also be treated. This is another reason why it is not possible to predict general prognoses and courses. The life expectancy of affected individuals is usually not affected by the disease mucinosis follicularis.
Prevention
There are no known proven, effective ways to prevent mucinosis follicularis.
Follow-up care
In most cases, only limited or very few measures of direct aftercare are available to the affected person with mucinosis follicularis. For this reason, the affected person should see a physician at an early stage to prevent the occurrence of other complications and complaints. It is not possible for the disease to heal on its own, so a doctor should be consulted at the first signs and symptoms of the disease. Most of those affected are usually dependent on taking various medications to alleviate or limit the symptoms. Regular intake and correct dosage should always be ensured. If there are any uncertainties or questions, a doctor must always be consulted first. Likewise, the doctor should also be contacted if there are changes and complaints on the skin. As a rule, no further or special follow-up measures are necessary in the case of mucinosis follicularis. In most cases, the life expectancy of the affected person is not reduced. In some cases, contact with other patients of the disease can also be useful, as it comes to an exchange of information.
What you can do yourself
Mucinosis follicularis can be alleviated by a healthy lifestyle. A balanced diet and adequate sunlight will reduce any inflammatory responses and improve overall well-being. The cornifications themselves can be treated by peelings and medicinal preparations. Preparations containing aloe vera and other pain– and inflammation-reducing substances are suitable. If these measures do not have any effect, the doctor should be consulted. It may be necessary to use a prescription product to reduce the skin lesions. In general, strict personal hygiene and regular changes of bed linen, towels, etc. help. In addition, the skin areas should not be scratched open, as this can lead to infections and scarring. If these measures also show no effect, it is necessary to go to the doctor again. Mucinosis follicularis can also be alleviated by a number of alternative remedies from natural medicine. Devil’s claw or sage, for example, but also lemon balm and ginseng, which can be drunk in the form of teas or applied as moist compresses to the cornifications, have proven effective. To avoid injury, the removal of the callus should be done by a doctor.
