Scleromyxedema associated with esophageal aperistalsis and dermal eosinophilia

Scleromyxedema (generalized lichen myxedematosus) is a rare variant of papular mucinosis characterized clinically by generalized waxy papules and marked cutaneous induration. Histologically, there is fibromucinous infiltration of the superficial dermis. Most patients also have had a monoclonal serum protein of cathodal mobility. The case to be presented is remarkable for the following reasons: 1. the presence of esophageal aperistalsis; 2. the presence of prominent dermal eosinophilia; and 3. the absence of a serum monoclonal paraprotein.