Cutaneous Mucinosis in a Patient With Eosinophilia-Myalgia Syndrome Associated With L-Tryptophan Ingestion

In 1990, a 37-year-old woman developed eosinophilia-myalgia syndrome (EMS) after increasing her dosage of L-tryptophan, which she was taking for a sleep disorder. She presented with a skin rash and hair loss. A skin biopsy confirmed the presence of cutaneous mucinosis, characterized by abnormal mucin deposition in the skin, but no signs of scleroderma-like syndrome were found. Although her eosinophil count normalized, the skin rash and new eruptions persisted. This case highlighted a new association between EMS and cutaneous mucinosis and contributed to the broader understanding of EMS's dermatological symptoms, which include rashes, scleroderma-like changes, and alopecia. However, the link between hair loss and the eosinophilia/myalgia in EMS and toxic oil syndrome was still not clear.