Severe proximal muscle weakness, polyarthritis, and symptoms resembling organic brain disease occur. Some of the ophthalmologic symptoms include ectropion and corneal opacities. Few patients may develop myeloma or Waldenstr m macroglobulinemia. Thyroid function tests are normal. The chest radiograph is usually normal in healthy patients.
Lesions demonstrate deposition of large amounts of mucin in the dermis.
Numerous plump stellate fibroblasts develop throughout the dermis. The mucin stains with periodic acid-Schiff, Alcian blue at pH 2.5 but not at pH 0.4, metachromatically with toluidine blue at pH 3.0, and has been identified as hyaluronic acid, an acid mucopolysaccharide. The treatment of lichen myxedematosus is very difficult and often ineffective. Many therapeutic agents have been tried including retinoids, orthovoltage radiation therapy, electron beam, corticosteroids, PUVA, plasmapheresis, extracorporal photophoresis, dermabrasion and carbon dioxide laser excision. There are various reports in the literature describing treatment successes and failures of these various methods.