Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2022;12(1):e2022043 1

Combined Epidermal-Follicular Mucinous Nevus: 
Dermoscopic Appearance

Arturo Robles-Tenorio1, Francisco Javier Salazar-Torres1

1 Dermatology Institute of Jalisco, “Dr. José Barba Rubio”, Zapopan, México

Citation: Robles-Tenorio A, Salazar-Torres FJ. Combined epidermal-follicular mucinous nevus: dermoscopic appearance.  
Dermatol Pract Concept. 2022;12(1):e2022043. DOI: https://doi.org/10.5826/dpc.1201a43

Accepted: July 17, 2021; Published: January 2022

Copyright: ©2022 Robles-Tenorio and Salazar-Torres. This is an open-access article distributed under the terms of the Creative 
Commons Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted 
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing interests: None.

Authorship: All authors have contributed significantly to this publication.

Corresponding author: Robles-Tenorio, MD, MSc, Dermatology Institute of Jalisco, “Dr. José Barba Rubio”, Zapopan, México.  
E-mail: arturo.robten@gmail.com

Case Presentation 

A 17-year-old Hispanic male presented with long-standing 

asymptomatic papules grouped as an irregular, brown, 

10 cm × 6 cm × 0.2 cm plaque over the right aspect of 

the neck (Figure 1A). Perifollicular hypopigmentation 

and geometric brown structures were observed on der-

moscopy (Figure 1B). Epidermal hyperkeratosis, acantho-

sis, papillomatosis, as well as abundant mucin deposits 

around the hair follicles were noted on histopathology, 

compatible with combined epidermal-follicular mucinous 

nevus (MN).

Figure 1. Combined epidermal-follicular mucinous nevus. (A) Clinical appearance. (B) Perifollicular hy-

popigmentation and pigmented geometric structures around the papules can be observed on dermoscopy. 



2 Image Letter | Dermatol Pract Concept. 2022;12(1):e2022043

Teaching Point

There are less than 30 reports of MN in the literature [1].  

Histopathology is essential for the diagnosis, wherein mucin 

deposits along the superficial dermis are present. The combined 

epidermal subtype also exhibits hyperkeratosis, acanthosis, and 

rete ridges elongation. Perifollicular mucinous involvement has 

only been described in one case, yet epidermal changes were 

subtle [2]. In contrast, we observed epidermal changes and per-

ifollicular mucin deposits, which correlated with perifollicular 

hypopigmentation observed in dermoscopy. The dermoscopic 

appearance of MN has not been previously documented.

Informed consent: Informed consent for publication of clini-

cal details and clinical  images was obtained from the patient.

References

1. Lepage W, Frouin É, Junca A, et al. Mucinous nevus of late onset. 

Ann Dermatol Venereol. 2016;143(8):547-553. DOI: 10.1016/ 

j.annder.2016.03.017. PMID: 27197785.

2. Oiso N, Kimura M, Kawada A. Follicular mucinous nevus: a 

possible new variant of mucinous nevus. J Am Acad Dermatol. 

2014;71(4):e141-e1422. DOI: 10.1016/j.jaad.2014.04.065. 

PMID: 25219735.