Systemic lupus erythmatosus and panniculitis presenting as multiple ulcers:one case report / 北京大学学报(医学版)

ABSTRACT

SUMMARY A 36-year-old woman had an 8-year history of systemic lupus erythematosus (SLE) and was being treated with 10 mg/d of prednisone.She presented with a 6-month history of intermittent fever and multiple painful multi skin erythematous macules in her button, hips and extremities that had slowly en-larged to 8 cm ×4 cm in diameter.The lesions started as painful erythematous macules, which eventually ulcerated and scared.Laboratory tests showed leukopenia, protenuria, positive anti-double strand DNA and hypocomplementemia.Cultures of the bottom ulcer were E.Coli, fugus and Tuberculous mycobacteria were both negative.Biopsy was performed and revealed necrosis of epidermis, thrombus and cellulose de-generation in epidermis with neutrophils karyorrhexis and vasculitis.Her SLE was active, so she was pre-scribed antibiotics for 2 weeks and prednisone was added to 60 mg/d for a month.However her skin ul-cers did not relieve.When prednisone was added to 120 mg/d with combination therapy of cyclophospha-mide and hydroxychloroquine, her skin ulcer cicatrized gradually.