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Cutaneous lupus

Margit Juhász, Megan Rogge, Mary Chen, Annette Czernik, Soo Jung Kim, Lauren Geller
This is a case report of a 16-year-old girl recently diagnosed with systemic lupus erythematosus (SLE) who presented with multiple blisters on the face, hands, arms, legs, trunk, and vaginal and oral mucosa. Skin biopsy was consistent with bullous SLE (BSLE). Dapsone is often the first-line treatment option for BSLE, but the patient's history of anemia and leukopenia and long-term immunosuppression requirement for her systemic symptoms raised concerns about dapsone and bone marrow toxicity, especially hemolytic anemia and agranulocytosis...
October 25, 2016: Pediatric Dermatology
V Sabater, F Ferrando, A Morera, L Palomar
Erythema annulare centrifugum (EAC) is a clinical reaction pattern that includes lupus erythematosus, spongiotic dermatitis (particularly pityriasis rosea), pseudolymphoma and cutaneous B-cell lymphoma. However, it can be the result of cutaneous metastasis by an internal carcinoma. We present the case of a 38-year-old woman with bilateral inflammatory breast cancer following multimodal therapy. After chemotherapy, the patient developed EAC on her back, clinically suspect of subacute cutaneous lupus erythematosus...
October 20, 2016: Clinical and Experimental Dermatology
Mar Llamas-Velasco, Victoria Alegría, Ángel Santos-Briz, Lorenzo Cerroni, Heinz Kutzner, Luis Requena
We review the most characteristic clinical and histopathologic findings of the cutaneous manifestations of the occlusive nonvasculitic vasculopathic disorders. Clinically, most of these conditions are characterized by retiform purpura. Histopathologic findings consist of occlusion of the vessel lumina with no vasculitis. Different disorders may produce nonvasculitic occlusive vasculopathy in cutaneous blood and lymphatic vessels, including embolization due to cholesterol and oxalate emboli, cutaneous intravascular metastasis from visceral malignancies, atrial myxomas, intravascular angiosarcoma, intralymphatic histiocytosis, intravascular lymphomas, endocarditis, crystal globulin vasculopathy, hypereosinophilic syndrome, and foreign material...
October 18, 2016: American Journal of Dermatopathology
Frane Banovic, Keith E Linder, Maarja Uri, Michael A Rossi, Thierry Olivry
BACKGROUND: Generalized discoid lupus erythematosus (GDLE) is a newly recognized canine variant of chronic cutaneous lupus erythematosus (CLE) that is not well characterized. HYPOTHESIS/OBJECTIVES: We report herein the signalment, clinical signs, treatment outcome, histopathology and immunological findings of 10 dogs with GDLE. METHODS: Inclusion criteria were: (i) a >3 month history of generalized skin lesions indicating a chronic or recurrent nature; (ii) skin lesions resembling those of human GDLE; (iii) histopathology of CLE (lymphocyte-rich interface dermatitis)...
October 16, 2016: Veterinary Dermatology
Mark A Strom, Girish C Mohan, Peter A Lio
Dermatologists frequently employ combination therapy to treat various diseases, but the evidence to support the use of such combinations is often lacking. Synergy is an appealing although somewhat ambiguous concept in medicine. Utilizing synergy allows clinicians to provide the most efficacious combination of treatments to patients, while potentially minimizing adverse effects and reducing the development of drug resistance. Definitions of synergy vary, but ultimately converge on finding a therapeutic advantage in combining treatments...
October 1, 2016: Journal of Drugs in Dermatology: JDD
Ana Karina Alves de Medeiros, Reinhart Speeckaert, Eline Desmet, Mireille Van Gele, Sofie De Schepper, Jo Lambert
The recent interest and elucidation of the JAK/STAT signaling pathway created new targets for the treatment of inflammatory skin diseases (ISDs). JAK inhibitors in oral and topical formulations have shown beneficial results in psoriasis and alopecia areata. Patients suffering from other ISDs might also benefit from JAK inhibition. Given the development of specific JAK inhibitors, the expression patterns of JAKs in different ISDs needs to be clarified. We aimed to analyze the expression of JAK/STAT family members in a set of prevalent ISDs: psoriasis, lichen planus (LP), cutaneous lupus erythematosus (CLE), atopic dermatitis (AD), pyoderma gangrenosum (PG) and alopecia areata (AA) versus healthy controls for (p)JAK1, (p)JAK2, (p)JAK3, (p)TYK2, pSTAT1, pSTAT2 and pSTAT3...
2016: PloS One
Luisa Moreira Silva, Willer Goncalves Dourado Santos, Mittermayer Barretto Santiago
The aim of this study was to review and evaluate systematically the scientific evidence on the relationship between systemic lupus erythematosus (SLE) and cutaneous warts (CW) caused by human papillomavirus (HPV) infection. With strict inclusion and exclusion criteria, we extensively searched the PUBMED, BVS (Virtual Health Library), and SCOPUS databases for the studies that evaluated the prevalence of CW in patients with SLE. Secondary references were additionally obtained from the selected articles. Only four articles met the research criteria and showed a higher frequency of CW in SLE patients compared to healthy controls...
September 30, 2016: Journal of Infection in Developing Countries
J K Presto, E Z Hejazi, V P Werth
Cutaneous lupus erythematosus (CLE) is an autoimmune skin disease occurring in association with or without systemic lupus erythematosus (SLE). Although antimalarials are widely used as the first-line systemic agent, refractory cases may benefit from additional immunomodulators, immunosuppressives, and biologics. An interest in biological therapies for CLE has emerged in recent years due to novel insight into the pathogenesis of CLE. These targets include B cells, T cells, and cytokines that are involved in immune system pathways...
September 29, 2016: Lupus
Laura Wuyts, Julie Dandelooy, Vasiliki Siozopolou, Julien Lambert, Olivier Aerts
INTRODUCTION: Jessner-Kanof disease (JKD), a lymphocytic infiltration of the skin, can be difficult to treat. Mepacrine (quinacrine), an anti-malarial less available in Belgium, may be beneficial. PATIENTS AND METHODS: Two female patients with biopsy-proven and therapy-resistant JKD, not responding to topical and systemic corticosteroids, (hydroxy-)chloroquine and/or dapsone, were treated with mepacrine 100 mg daily. RESULTS: In both patients an amelioration was observed during the first month of treatment, and clinical remission was obtained by the fourth month, without any side-effects...
August 10, 2016: Journal of Dermatological Treatment
M N Drehmer, D Andrade, I A Pereira, A R Marrero, Y C N Muniz, I R de Souza, S E Löfgren
BACKGROUND: Estrogens have a modulatory effect on several immune responses, many of which are correlated to autoimmune diseases. Estrogens act through binding to their receptors, and an overexpression of these receptors has been identified in patients with different autoimmune diseases. Here we analyzed the association of a putative functional genetic variant in the main estrogen receptor (ERα) gene (ESR1), and the susceptibility to clinical findings and severity of SLE. METHODS: A total of 426 individuals (266 healthy controls and 160 SLE patients) were genotyped for the polymorphism rs2234693 in the ESR1 gene...
September 27, 2016: Lupus
Hua Lei, Gui-E Ma, Zhenjun Liu
BACKGROUND: A facial depression deformity secondary to lupus erythematosus panniculitis results from fat necrosis, which seriously alters the patients' appearance and thus affects their psychological health. Few studies have discussed the repair of depression deformities. The authors repaired depression deformities due to atrophic lesions by using autologous fat grafting to obtain volumetric restoration of the facial skin, and the authors report our outcomes. METHODS: In this series, 30 depression deformities in 18 patients were repaired...
October 2016: Journal of Craniofacial Surgery
Jasmine N Stannard, Tamra J Reed, Emily Myers, Lori Lowe, Mrinal K Sarkar, Xianying Xing, Johann E Gudjonsson, J Michelle Kahlenberg
Cutaneous lupus erythematosus (CLE) is a disfiguring and common manifestation in systemic lupus erythematosus (SLE), and the etiology of this predisposition for cutaneous inflammation is unknown. Here, we sought to examine the keratinocyte as an important source of IL-6 and define the mechanism for its increased production in CLE. Evaluation of discoid and subacute cutaneous lupus erythematosus lesions revealed significant epidermal upregulation of IL-6 when compared with control via real-time PCR and immunohistochemistry...
September 16, 2016: Journal of Investigative Dermatology
Marjon Vatanchi, Kaivon Sobhani, Valerie T Fisher, Jeffrey J Meffert
BACKGROUND: Sarcoidosis is a multisystemic granulomatous disease of unknown origin. Chronic cutaneous lupus erythematosus (CCLE) is an autoimmune disease that is associated with autoantibody production and T-cell dysfunction. Cutaneous manifestations of sarcoidosis may mimic CCLE and vice versa making it difficult to reach a diagnosis clinically. CASE PRESENTATION: We present a case of a 57-year-old woman with long-standing sarcoidosis who presented to clinic with diffuse painful plaques that were very distinct and suggestive of CCLE...
2016: BMC Dermatology
R Karkouche, C Bernigaud, J Fontugne, O Zehou, G Bellaud, M N'Diaye, K Cherif, P Wolkenstein, O Chosidow, N Ortonne, S Ingen-Housz-Oro
BACKGROUND: Equestrian cold panniculitis has been described since 1980 in horse riders or in stable employees. Histological aspect is underdescribed. PATIENTS AND METHODS: We describe clinical and histological features of six horse riding or stable employees patients presenting with upper lateral thigh lesions during the winter months between 2014 and 2016 in our dermatological department. RESULTS: Six horse riding or stable employees ladies without any known disease presented with similar symptoms...
September 16, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Juliya Fisher, Mital Patel, Michael Miller, Katy Burris
Drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) has been associated with numerous drugs, but there are limited reports of its association with aromatase inhibitor anastrozole. We report the case of a patient undergoing treatment with anastrozole for breast cancer who presented with clinical, serological, and histological evidence consistent with DI-SCLE. Her condition quickly began to improve after the use of anastrozole was discontinued and hydroxychloroquine therapy was initiated. Cases such as ours as well as several others that implicate antiestrogen drugs in association with DI-SCLE seem to be contradictory to studies looking at the usefulness of treating systemic lupus erythematosus (SLE) with antiestrogen therapy...
August 2016: Cutis; Cutaneous Medicine for the Practitioner
Nathalie Costedoat-Chalumeau, Laetitia Coutte, Véronique Le Guern, Nathalie Morel, Gaelle Leroux, Romain Paule, Luc Mouthon, Jean-Charles Piette
The catastrophic antiphospholipid syndrome (CAPS) develops in at least 1% of patients with antiphospholipid syndrome, either primary or associated with systemic lupus erythematosus. CAPS reveals the antiphospholipid syndrome in about 50% of cases. The CAPS is characterized by rapidly-progressive widespread thromboses mainly affecting the microvasculature in the presence of antiphospholipid antibodies. In a few days, the patients develop multiorgan failure with renal insufficiency with severe hypertension, pulmonary, cerebral, cardiac, digestive and/or cutaneous involvement...
September 9, 2016: La Presse Médicale
S Kaur, P Sahu, S Dayal, V K Jain, N Jindal, V Jairath
Cutaneous Squamous cell carcinoma (SCC) is the second most common form of non-melanotic skin cancer after basal cell carcinoma (BCC). It is a well-known complication of discoid lupus erythematosus (DLE) and usually favours the depigmented lesions located over sun-exposed areas. The clinical course of this complication may be aggressive, with a high risk of mortality. Literature describes numerous case reports of SCC complicating the lesions of DLE but mutilating SCC is rarely mentioned. Here in, we report a rare case of mutilating squamous cell carcinoma arising in an early (two years duration) lesion of DLE...
February 22, 2016: West Indian Medical Journal
Enzo Errichetti, Giuseppe Stinco
Over the last few years, dermoscopy has been shown to be a useful tool in assisting the noninvasive diagnosis of various general dermatological disorders. In this article, we sought to provide an up-to-date practical overview on the use of dermoscopy in general dermatology by analysing the dermoscopic differential diagnosis of relatively common dermatological disorders grouped according to their clinical presentation, i.e. dermatoses presenting with erythematous-desquamative patches/plaques (plaque psoriasis, eczematous dermatitis, pityriasis rosea, mycosis fungoides and subacute cutaneous lupus erythematosus), papulosquamous/papulokeratotic dermatoses (lichen planus, pityriasis rosea, papulosquamous sarcoidosis, guttate psoriasis, pityriasis lichenoides chronica, classical pityriasis rubra pilaris, porokeratosis, lymphomatoid papulosis, papulosquamous chronic GVHD, parakeratosis variegata, Grover disease, Darier disease and BRAF-inhibitor-induced acantholytic dyskeratosis), facial inflammatory skin diseases (rosacea, seborrheic dermatitis, discoid lupus erythematosus, sarcoidosis, cutaneous leishmaniasis, lupus vulgaris, granuloma faciale and demodicidosis), acquired keratodermas (chronic hand eczema, palmar psoriasis, keratoderma due to mycosis fungoides, keratoderma resulting from pityriasis rubra pilaris, tinea manuum, palmar lichen planus and aquagenic palmar keratoderma), sclero-atrophic dermatoses (necrobiosis lipoidica, morphea and cutaneous lichen sclerosus), hypopigmented macular diseases (extragenital guttate lichen sclerosus, achromic pityriasis versicolor, guttate vitiligo, idiopathic guttate hypomelanosis, progressive macular hypomelanosis and postinflammatory hypopigmentations), hyperpigmented maculopapular diseases (pityriasis versicolor, lichen planus pigmentosus, Gougerot-Carteaud syndrome, Dowling-Degos disease, erythema ab igne, macular amyloidosis, lichen amyloidosus, friction melanosis, terra firma-forme dermatosis, urticaria pigmentosa and telangiectasia macularis eruptiva perstans), itchy papulonodular dermatoses (hypertrophic lichen planus, prurigo nodularis, nodular scabies and acquired perforating dermatosis), erythrodermas (due to psoriasis, atopic dermatitis, mycosis fungoides, pityriasis rubra pilaris and scabies), noninfectious balanitis (Zoon's plasma cell balanitis, psoriatic balanitis, seborrheic dermatitis and non-specific balanitis) and erythroplasia of Queyrat, inflammatory cicatricial alopecias (scalp discoid lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia and folliculitis decalvans), nonscarring alopecias (alopecia areata, trichotillomania, androgenetic alopecia and telogen effluvium) and scaling disorders of the scalp (tinea capitis, scalp psoriasis, seborrheic dermatitis and pityriasis amiantacea)...
September 9, 2016: Dermatology and Therapy
M Pourazizi, S Kabiri, A Saffaei, B Abtahi-Naeni
Misnomers are terms for any of medical conditions whose name does not reflect the pathophysiological reality. In the field of dermatology, it is interesting to note that there are some misnomers about lupus. Lupus is Latin for wolf, and it comes from the facial appearance that was thought to resemble the bites of a wolf. Until the 19th century, lupus was most commonly caused by cutaneous tuberculosis (TB), so some of the misnomer related to TB. Other misnomers encountered in lupus have arisen from the lack of understanding of the underlying etiology, pathogenesis and histopathological features, due to imprecise translations...
September 6, 2016: Lupus
Ichiro Katayama
This chapter summarizes recent advances in the pathogenesis and management of Sjögren's syndrome (SS). Major topics are newly described pathomechanisms and cutaneous manifestations of SS, with special references to hypohidrosis and related mucocutaneous manifestations. Although the significance of cutaneous manifestations in SS has been gradually recognized in rheumatologists, sudomotor function has not been fully evaluated and recognized in the diagnosis of SS except by dermatologists. SS is a relatively underestimated collagen disease in contrast to systemic lupus erythematosus, systemic sclerosis, or dermatomyositis, and special care is needed not to misdiagnose SS when we see patients with common skin diseases such as drug eruption, infectious skin disease, or xerosis in daily practice...
2016: Current Problems in Dermatology
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