ABSTRACT
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.
Subject(s)
Adult , Female , Humans , Arthritis, Rheumatoid , Extremities , Lupus Erythematosus, Cutaneous , Lupus Erythematosus, Systemic , Panniculitis, Lupus Erythematosus , AdalimumabABSTRACT
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.
Subject(s)
Adult , Female , Humans , Arthritis, Rheumatoid , Extremities , Lupus Erythematosus, Cutaneous , Lupus Erythematosus, Systemic , Panniculitis, Lupus Erythematosus , AdalimumabABSTRACT
Kikuchi's disease (KD), histiocytic necrotizing lymphadenitis, is a rare self-limited lymphadenopathy, which usually affects young women. KD has been reported to precede, coexist with or follow the diagnosis of other entities, such as systemic lupus erythematosus (SLE), adult-onset Still's disease, Hashimoto's disease, and viral infections. In a few cases, KD is associated with cutaneous lupus erythematosus (CLE), without systemic involvement. Herein, we report the first Korean case of KD associated with lupus erythematous profundus in a 9-year-old boy.
Subject(s)
Child , Female , Humans , Hashimoto Disease , Histiocytic Necrotizing Lymphadenitis , Lupus Erythematosus, Cutaneous , Lupus Erythematosus, Systemic , Lymphatic Diseases , Panniculitis, Lupus Erythematosus , Still's Disease, Adult-OnsetABSTRACT
We present a case of a young male with a five year history of a hair-loss patch presenting linear distribution on the scalp. A biopsy specimen revealed a lymphocytic panniculitis and fat degeneration with mucin deposit. Focal hydropic degeneration of basal cells was also evident. Direct immuno-fluorescence revealed peribulbar granular deposits of IgM, IgA and C3. Antinuclear antibody was negative. Clinical appearance was unusual but histological examination revealed linear lupus erythematosus profundus. To our knowledge, only one other case of linear lupus erythematosus profundus on the scalp has been reported in English written literature until now.
Subject(s)
Humans , Male , Alopecia , Antibodies, Antinuclear , Biopsy , Immunoglobulin A , Immunoglobulin M , Mucins , Panniculitis , Panniculitis, Lupus Erythematosus , ScalpABSTRACT
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.
Subject(s)
Child , Female , Humans , Young Adult , Incidence , Lupus Erythematosus, Cutaneous , Lupus Erythematosus, Discoid , Panniculitis, Lupus Erythematosus , SkinABSTRACT
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.
Subject(s)
Humans , Cheek , Follow-Up Studies , Panniculitis, Lupus Erythematosus , Retrospective StudiesABSTRACT
A 50-year-old woman with lupus erythematosus profundus of about a year's duration was reported. The patient had no history of discoid lupus erythematosus or systemic lupus erythematosus. Dermatologic examination revealed two, firm, freely movable, well demarcated, subcutaneous plaques, with mildly erythematous overlying skin, measuring 2 x 2 cm (right), 5 x 5 cm (left), was present on the both deltoid region. Histopathologically, this showed panniculitis. Diret immunofluorescence studies showed IgG and IgM deposition on the dermoepidermal junction.
Subject(s)
Female , Humans , Middle Aged , Fluorescent Antibody Technique , Immunoglobulin G , Immunoglobulin M , Lupus Erythematosus, Discoid , Lupus Erythematosus, Systemic , Panniculitis , Panniculitis, Lupus Erythematosus , SkinABSTRACT
A 56-year-old woman presenting a 10-year history of atrophic discoid patches with underlying subcutaneous nodules was seen. These skin lesions were distributed on the upper arms bilaterally. Biopsy specimens taken from the lesional skin showed epidermal and dermal changes consistent with the discoid lesions of the cutaneous lupus erythematosus. Deep dermis and subcutaneous fat tissue revealed sclerosis and fibrinoid alterations of the collagen and necrosis of fat cells, the features corresponding to the lupus ei ythematosus profundus. She had no laboratory evidences suspective of systemic lupus erythematosus or other connective tissue diseases. This patient with lupus erythernatosus profundus which cleveloped subsequent to the discoid lesion is consiclered to be a rarely encounteririg observation in lupus erythematosus.