No abstract available.
Panniculitis, Lupus Erythematosus*

Panniculitis, Lupus Erythematosus*

Introduction: Lupus panniculitis (LP) is an unusual type of cutaneous lupus erythematosus (CLE) wherein the cutaneous inflam- matory reaction involves primarily the deeper dermis and subcutaneous fat. It is characterized by the appearance of recurrent, mostly asymptomatic, firm, nodules or plaques, involving the face, upper limbs, and buttocks. Case report: In our case, a 30-year-old female presented with a non-tender, non-movable nodule on the left breast, 6 weeks prior to her admission. She had fever, chills, and joint pains. The patient later developed hyperpigmented plaques on the infra- clavicular area, and left flank extending to the abdomen. Urinalysis showed proteinuria, and RBC cast. She also had leukopenia, and anemia on CBC. Chest computerized tomography (CT) scan revealed a heterogeneously enhancing soft tissue mass in the base of the neck at the right infraclavicular region with malignant features. ANA titer was normal, while skin biopsy on two sites and direct immunofluorescence studies were compatible with lupus panniculitis. She was managed as a case of systemic lupus erythematosus (SLE) using a combination of hydroxychloroquine, and oral corticosteroids, which afforded temporary relief of symptoms. The patient however was lost to follow-up and opted for alternative medicine, and subsequently succumbed to the complications of SLE. Conclusion This case highlights the importance of a carefully made assessment after an accurate clinicopathological cor- relation was done. This case also emphasizes that although LP if associated with SLE may signify a milder condition, judicious monitoring and follow-up must still be undertaken since management is based on the disease activity.
Panniculitis, Lupus Erythematosus

The clinical manifestations and immunohistologic findings of drug-induced lupus erythematosus (DILE) are similar to those of idiopathic lupus. However, DILE is different from idiopathic lupus because it is induced after continuous drug exposure and resolves after discontinuation of the causative drug. DILE can be divided into systemic lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous lupus erythematosus (CCLE). Lupus erythematosus profundus is a subtype of CCLE, and drug-induced CCLE is very rarely reported in the literature. Herein, we report a rare case of adalimumab-induced lupus erythematosus profundus developed in a rheumatoid arthritis patient. The patient is a 43-year-old Korean woman who had multiple tender nodules and plaques on her face, trunk, and both extremities after using adalimumab for rheumatoid arthritis. She was diagnosed with adalimumab-induced lupus erythematosus profundus, and her condition improved after discontinuation of adalimumab.
Adult ; Arthritis, Rheumatoid* ; Extremities ; Female ; Humans ; Lupus Erythematosus, Cutaneous ; Lupus Erythematosus, Systemic ; Panniculitis, Lupus Erythematosus* ; Adalimumab

The clinical manifestations and immunohistologic findings of drug-induced lupus erythematosus (DILE) are similar to those of idiopathic lupus. However, DILE is different from idiopathic lupus because it is induced after continuous drug exposure and resolves after discontinuation of the causative drug. DILE can be divided into systemic lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous lupus erythematosus (CCLE). Lupus erythematosus profundus is a subtype of CCLE, and drug-induced CCLE is very rarely reported in the literature. Herein, we report a rare case of adalimumab-induced lupus erythematosus profundus developed in a rheumatoid arthritis patient. The patient is a 43-year-old Korean woman who had multiple tender nodules and plaques on her face, trunk, and both extremities after using adalimumab for rheumatoid arthritis. She was diagnosed with adalimumab-induced lupus erythematosus profundus, and her condition improved after discontinuation of adalimumab.
Adult ; Arthritis, Rheumatoid* ; Extremities ; Female ; Humans ; Lupus Erythematosus, Cutaneous ; Lupus Erythematosus, Systemic ; Panniculitis, Lupus Erythematosus* ; Adalimumab

Lupus panniculitis is an uncommon clinical variant of cutaneous lupus erythematosus. The cutaneous lesions of lupus panniculitis are characterized by subcutaneous nodules or plaques. The overlying skin can often appear unchanged, but may also be associated with discoid lupus erythematosus and appear erythematous, atrophic, telangiectatic or poikilodermatous. The mean age of incidence is between 30~40 years, and children are rarely affected. Furthermore, a linear distributions of the lesions has rarely been reported. We herein describe a case of 8-year-old girl with linear lupus panniculitis on the face, and propose that the possibility of this disease be considered in cases where linear subcutaneous nodular lesions occur in children or young adults.
Child* ; Female ; Humans ; Incidence ; Lupus Erythematosus, Cutaneous ; Lupus Erythematosus, Discoid ; Panniculitis, Lupus Erythematosus* ; Skin ; Young Adult

BACKGROUND: Lupus erythematosus profundus (LEP) is an unusual clinical variant of lupus erythematosus (LE). It is unclear which part LEP occupied in the disease spectrum of LE. OBJECTIVE: Clinical and histopathological studies were performed on 19 patients with LEP in order to further define the clinical patterns, know the various serological findings, and review the histopathological features. METHODS: A retrospective review was carried out of the clinical records and histopathological specimens of 19 patients with LEP. RESULTS: The most common clinical features were indurated nodules or plaques on the cheek. There was a 37% positivity in the ANA test. Histopathogically epidermal changes as well as subcutaneous involvements were common. There were no cases of newly developed SLE during the follow up period of 41 months. CONCLUSION: Most patients with LEP have a relatively benign disease course, although a few develop systemic abnormalities and have abnormal laboratory findings.
Cheek ; Follow-Up Studies ; Humans ; Panniculitis, Lupus Erythematosus ; Retrospective Studies

Lupus panniculitis is a chronic inflammatory disease of subcutaneous fat that occurs in 2~3% of patients with systemic lupus erythematosus. Lupus panniculitis typically presents with firm, indurated subcutaneous nodules or plaques commonly developed in proximal extremities, trunk, head and neck. Breast involvement with lupus panniculitis (lupus mastitis) has been infrequently reported. We experienced a case of lupus mastitis developed in a 44-year-old female confirmed by histologic features and laboratory findings. Antimalarial therapy resulted in the complete resolution of the lesions.
Adult ; Breast* ; Extremities ; Female ; Head ; Humans ; Lupus Erythematosus, Systemic ; Mastitis ; Neck ; Panniculitis, Lupus Erythematosus* ; Subcutaneous Fat

Lupus profundus is a rare subtype of chronic cutaneous lupus erythematosus, which shows a tender subcutaneous nodule or plaque. The face, arm, buttock, trunk and thighs are frequently involved. Lupus profundus can be associated with or without systemic lupus erythematosus. But due to its rarity, it is difficult to diagnosis and there are not many reports regarding its characteristics, including its distribution. In this case, a 13-year-old boy has visited with several violaceous non-tender nodules on Lt. upper thigh with segmental distribution, which follows the Blaschko's line. Through skin biopsy and its immunoflourescent study, we diagnosed lupus profundus. We here report a case of lupus profundus with segmental distribution following the lines of Blaschko's in a child.
Arm ; Biopsy ; Buttocks ; Child ; Humans ; Leg ; Lupus Erythematosus, Cutaneous ; Lupus Erythematosus, Systemic ; Panniculitis, Lupus Erythematosus ; Skin ; Thigh

Although systemic lupus erythematosus (SLE) is a chronic inflammatory multi-system disease characterized by protean manifestations, there were a few reports of breast involvement in patients with SLE. Histopathologically, most cases show lupus panniculitis. We report a 26-year-old female patient with SLE presenting with breast fat necrosis and biopsy revealed lymphocytic leukocytoclastic vasculitis and subacute cutaneous lupus erythematosus, rather then lupus panniculitis. Patient received hydroxychloroquine and prednisolone with an improvement of breast necrosis.
Adult ; Biopsy ; Breast* ; Fat Necrosis* ; Female ; Humans ; Hydroxychloroquine ; Lupus Erythematosus, Cutaneous ; Lupus Erythematosus, Systemic* ; Necrosis ; Panniculitis, Lupus Erythematosus ; Prednisolone ; Vasculitis