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Arch Dermatol ; 148(2): 190-3, 2012 Feb.
Article in English | MEDLINE | ID: mdl-22004879

ABSTRACT

OBJECTIVE: To investigate whether tissue eosinophilia is a differentiating histopathologic feature of drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) compared with non-DI-SCLE. DESIGN: Retrospective medical record review with prospective blinded histopathologic analysis. SETTING: University-affiliated dermatology and dermatopathology practice. PATIENTS: Fifty-nine patients with SCLE were divided into DI (n = 15) and non-DI (n = 44) groups. MAIN OUTCOME MEASURES: A dermatopathologist masked to the etiologic associations reviewed corresponding histopathologic specimens. For each patient, an eosinophil ratio was calculated as the mean eosinophil score (averaging eosinophil counts from 10 high-power histologic fields) divided by the intensity of inflammation. Eosinophil ratios for both groups were compared using the Mann-Whitney test. RESULTS: No significant difference was found in mean eosinophil ratios in the DI vs non-DI groups (0.11 vs 0.004; P = .34). Mucin deposition was present in both populations and was not significantly different (P = .18). The inflammatory infiltrate was superficial and deep in 10 patients (67%) in the DI group vs 24 (55%) in the non-DI group. Periadnexal inflammation was observed in 12 patients (80%) in the DI group vs 37 (84%) in the non-DI group, and basal layer liquefaction with dyskeratosis was seen in 15 patients (100%) in the DI group and in 37 (84%) in the non-DI group. CONCLUSIONS: Tissue eosinophilia is not a differentiating histopathologic feature of DI-SCLE. Careful review of a patient's drug history in correlation with clinical findings remains the standard for identifying a drug as an etiologic or exacerbating factor in patients with SCLE.


Subject(s)
Drug Eruptions/pathology , Eosinophilia/pathology , Leukocyte Count , Lupus Erythematosus, Cutaneous/chemically induced , Lupus Erythematosus, Cutaneous/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy , Eosinophilia/etiology , Eosinophils , Female , Humans , Lupus Erythematosus, Cutaneous/blood , Male , Middle Aged , Mucins/analysis , Retrospective Studies , Single-Blind Method , Statistics, Nonparametric , Young Adult
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