Lupus Panniculitis: Clinico-histopathological Analysis of a Case Series / 대한류마티스학회지

ABSTRACT

OBJECTIVE: Lupus erythematosus panniculitis (LEP) is a rare subtype of chronic cutaneous LE. Until now, a few studies about the clinico-histopathological data of LEP have been conducted in Korea. The aim of this study was to investigate clinical, serological, and histopathologic features of LEP. METHODS: The clinical survey was retrospectively performed through the available medical records in 15 cases with LEP. The histopathologic, serologic and clinical findings were included in this analysis. RESULTS: LEP occurred primarily in females (FM=41). The mean age at diagnosis was 37.5 years. 20% (3/15) of the patients was associated with SLE. DLE was accompanied with LEP in 26.6% (4/15). The predilectional sites were as follows in order upper limbs (33.3%), lower limbs (20%), trunk (26.6%), buttock (13.3%) and face (6.6%). The fluorescent antinuclear antibody (FANA) was positive in 46% (7/15) of all cases. The main histopathologic characteristics of LEP were lymphocytic lobular panniculitis (100%), hyaline degeneration (86.6%), lymphoid aggregates (60%), mucin deposition (60%), lymphocytic vasculitis (40%). The treatment included anti-malarial agents, systemic corticosteroid, dapsone, intralesional triamcinolone injection. Although significant remission was proven in most cases (86.6%) of LEP, they represented a chronic relapsing course (83.3%). CONCLUSION: LEP is a chronic inflammatory disease of subcutaneous adipose tissue that can develop during the course of SLE. Evaluation of patients suspected of having LE panniculitis should include a complete history taking and physical examination as well as serologic studies, determination of peripheral blood counts, and tests of renal function.