Case Study: February 2017

History A 45 year old male presents with bilateral upper lid dermatochalasia and undergoes bilateral blepharoplasties. His medical history includes rheumatoid arthritis.

Fig 1-skin

Fig 2-Toluidine blue stain.


1. What does figure 1 show?

2. What does figure 2 show?

3. What is the hitopathological reaction pattern?

4. Is there any relevance to the patient’s past medical history?

Click to show answers


1. Rather ‘oedematous’ skin at low power.

2. Metachromatic mucin (purple stringy material).

3. Dermal / cutaneous mucinosis

4. Secondary dermal mucinoses are associated with autoimmune connective tissue disorders.