What is alopecia mucinosis & how to treat them ?

 WHAT IS ALOPECIA MUCINOSA ?

Alopecia mucinosa, also known as follicular mucinosis , describes the appearances of mucin around hair follicles as seen under the microscope . it is characterised by bald patches  of skin in which hair follicles are prominent . 


Mucin look like stringly clear or whitish goo mainly composed of hyaluronic acid, a normal component  of the ground substances surrounding collagen in the dermis. Several other forms of mucinosis are described and classified . 

  • a primary and acute disorder occuring in children and adolescents .
  • a primary and chronic disorder occuring in people older than 40 years .
  • a secondary disorder associated with benign or malignant skin disease
  • urticaria like follicular mucinosis . 

Pictures of Alopecia Mucinosa :







What causes of alopecia mucinosa ?

The causes of alopecia  mucinosa  is unknown , but it may have something to do with circulating immune complexes and cell -  mediated  immunity . Is that mucinous  material deposits and accumulates in hair follicles and sebaceous glands to create an inflammatory condition that subsequently  breaks down the ability of the affected follicles to produce hair . 

What are the features of alopecia mucinosa ?

Alopecia mucinosa most commonly affects face , neck and scalp , but any part of the body may be affected . 


  • it presents as grouped follicular papules within reddened , dry , patches or plaques. 
  • one or more lesions may be present from onset or a single  lesion may  develop  to multiple  lesion over a few weeks or months . 
  • patches or plaques are usually 2-5 cm in diameter but can be larger . 
  • Hair loss is non scarring and potentially reversible in the early stages , but in more advanced disease  the hair follicles are destroyed , causing scarring alopecia . 
Primary and acute alopecia mucinosa 
  • Affects people < 40 years . 
  • Usually , only one or a few lesions arise . 
  • They are often located on the head , neck and upper arm . 
  • Most resolve spontaneously within 2 months to 2 years . 

Primary and chronic alopecia mucinosa 
  • Affects people > 40 years 
  • Widespread and often numerous lesion may persist or recur indefinitely 
  •  it presents as flat or raised patches  that  may rarely ulcerate 
  • permanently bald patches are studded with horny plugs
  • sometimes mucin can be squeezed out of affected follicles 

Urticaria - like follicular mucinosis 
  • presents as itchy small bumps or raised areas 
  • these are mostly found on the head and neck 
Secondary alopecia mucinosa 
  • Affects people > 40 years 
  • Follicular  mucinous degeneration may arise in inflammatory skin diseases  such as lupus erythematosus and lichen simplex . 
  • It may also arise in malignant disease such as cutaneous T cell lymphoma , kaposi sarcoma and hodgkin lymphoma 
  • Skin features typical  of teh underlying  disease may also be present 
  • A skin biopsy  is necessary to distinguish these from primary alopecia mucinosa

What are the treatments for alopecia mucinosa ?



There is no proven effective treatments for alopecai mucinosa. usually , primary and acute alopecia muinosa occurring in children  resolves  spontaneously . There is a small chance of spontaneous resolution  for  other forms of the disease, the effects of treatment  can be difficult to assess. some treatments that have been tired with limited success include :

  • Topical , intralesional and systemic  corticosteroids 
  • Oral antibiotics such as minocycline 
  • Dapsone 
  • Indomethacin 
  • interferons 
  • topical and systemic photochemotherapy 
  • topical nitrogen mustard 
  • Radiation therapy 
  • UVA1 phototherapy 
  • Topical bexarotene 1%gel 

Secondary alopecia mucinosa should be treated appropriately for the underlying skin disease , particular if it is cutaneous T cell lymphoma . 



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