Acral persistent papular mucinosis has been thought to be a distinct for of cutaneous mucinosis not associated with systemic diseases. It was recently classified as one of five subtypes of localized lichen mixedematosus. A 64-year-old man presented with a 15-year history of flesh-colored to translucent papules and a few round hypopigmented patches on his wrists, back of the hands, and distal forearms. Biopsy from the papular lesions revealed focal mucin accumulation in the upper reticular dermis. The clinical and histopathological features were consistent with acral persistent papular mucinosis.