Macroscopic and microscopic mucinosis in chronic sclerodermoid graft-versus-host disease

Secondary cutaneous mucinosis is a well-recognized feature of connective ti ssue diseases such as lupus erythermatosus and dermatomyositis. We report t he first three cases of dermal mucinosis in association with severe chronic cutaneous graft-versus-host disease of the sclerodermoid variety. One pati ent had clinical changes due to abundant mucin accumulation within the papi llary dermis (mucinoma). In the other two patients histological examination revealed extensive deposits of mucin predominantly within the reticular de rmis. The microscopic appearances were striking, with numerous vacuolated s paces interspersed between collagen bundles. We speculate that this appeara nce is the result of ground substance becoming trapped within grossly scler odermoid connective tissue.