scholarly journals Histopathological Review on Discoid Lupus Erythematous Mimicking Granuloma Faciale

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Putti Fatiharani Dewi ◽  
Fiska Rosita ◽  
Triasari Oktavriana ◽  
Ambar Mudigdo
Keyword(s):  
Lupus Erythematosus ◽  
Histopathological Examination ◽  
Cutaneous Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Basal Membrane ◽  
Discoid Lupus Erythematosus ◽  
Cell Degeneration ◽  
Granuloma Faciale ◽  
The Face ◽  
Erythematous Plaques

Discoid lupus erythematosus is the most common forms of chronic cutaneous lupus erythematosus. It is characterized by clinical manifestations of erythematous macules, papules, or plaques with a coin-like shape and the face is the most common predilection site. Clinical features often resemble granuloma faciale. This case report aimed to distinguish discoid lesions on the face based on the histopathological examination. A 71-year-old male with a few reddish lumps appeared on his face since three months ago. Physical examination showed multiple discrete erythematous plaques with overlying squamous. Hematoxylin and eosin staining on the epidermis demonstrated basket weave type orthokeratosis, basal vacuolar cell degeneration, epidermal atrophy with flat rete ridges, and follicular plugging while in the dermis obtained inflammatory cell infiltrates, especially in periadnexal areas. Histopathological features of DLE are hyperkeratosis, pilosebasea gland atrophy, follicular plugging, basal membrane thickening, and cellular infiltrate in periadnexa or perivascular areas more visible than in other types of CLE. In DLE, no subepidermal gren zone and eosinophil infiltrate were found, like histological features of granuloma faciale. Histopathological examination can be used to establish a diagnosis for discoid lesions on the face, although serology examination remains as the gold standart. Keywords:  Discoid lupus erythematosus; Granuloma faciale; Histopathology

scholarly journals Lupus Erythematosus: Cutaneous Manifestations and Treatment

2019 ◽  
Vol 77 (3) ◽  
pp. 201-214
Author(s):  
Francisca Alves ◽  
Margarida Gonçalo
Keyword(s):  
Lupus Erythematosus ◽  
Systemic Disease ◽  
Cutaneous Lupus Erythematosus ◽  
Disease Patient ◽  
Clinical Manifestations ◽  
Disease Diagnosis ◽  
Direct Immunofluorescence ◽  
Discoid Lupus Erythematosus ◽  
Topical Steroids ◽  
Cutaneous Manifestations

Cutaneous lupus erythematosus (CLE) includes a broad range of dermatologic manifestations, which may or may not be associated with systemic manifestations. Specific CLE - defined by the presence of an interface dermatitis on histopathological evaluation - is divided into several sub-types, namely acute CLE (ACLE), subacute CLE (SCLE) and chronic CLE (CCLE). CCLE includes discoid lupus erythematosus (DLE), as well as other rarer forms such as LE profundus (LEP). Nonspecific skin findings, such as livedo reticularis or purpura are more frequently seen in patients with systemic disease. Diagnosis requires classification of the subtype, through a combination of physical examination, laboratory studies, histology and sometimes direct immunofluorescence, at the same time ensuring to exclude systemic disease. Regarding the treatment of CLE, antimalarials and topical steroids continue to be the standard of care; however, immunosuppressants, thalidomide analogs and monoclonal antibodies are possible systemic therapies for recalcitrant disease. Patient education on proper sun protection and avoidance of triggers is crucial. This paper reviews the clinical manifestations of CLE, as well as the treatment.

scholarly journals Atypical dermatophytosis in a case of systemic lupus erythematosus

2020 ◽  
Vol 11 (e) ◽  
pp. e165.1-e165.3
Author(s):  
Manjunath M Shenoy ◽  
Goutham Kilaru ◽  
Ashmiya Razak ◽  
Malcolm Pinto
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Cutaneous Lupus Erythematosus ◽  
Autoimmune Disorder ◽  
Laboratory Evaluation ◽  
Systemic Lupus ◽  
Cutaneous Manifestations ◽  
Therapeutic Implications ◽  
The Face ◽  
Erythematous Plaques

Systemic lupus erythematosus (SLE) is a multiorgan autoimmune connective tissue disease with many muco-cutaneous manifestations. We report a case of SLE on treatment presented with scaly erythematous plaques on the trunk and extremities and diffuse scaly erythematous macular lesions on the face resembling cutaneous lupus erythematosus. Laboratory evaluation established a diagnosis of tinea corporis with faciei. He responded to long term itraconazole therapy. This case focuses on the modification of tinea in an autoimmune disorder on immunosuppressive therapy and its therapeutic implications.

The combined role of clinical, reflectance confocal microscopy and dermoscopy applied to chronic discoid cutaneous lupus and subacutus lupus erythematosus: A case series and literature review

Lupus ◽  
2020 ◽  
Vol 30 (1) ◽  
pp. 125-133
Author(s):  
Sara Mazzilli ◽  
Laura Vollono ◽  
Laura Diluvio ◽  
Elisabetta Botti ◽  
Gaetana Costanza ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Lupus Erythematosus ◽  
Cutaneous Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Case Series ◽  
Skin Lesions ◽  
Reflectance Confocal Microscopy ◽  
Discoid Lupus Erythematosus ◽  
Cutaneous Lupus

Main subtypes of cutaneous lupus erythematosus are represented by acute, subacute cutaneous, intermittent and chronic cutaneous lupus erythematosus. Discoid lupus erythematosus represents the most common phenotype of chronic cutaneous lupus erythematosus. The spectrum of clinical manifestations mirrors that of several and distinct histopathological features. Such variability among different CLE subtypes is also observed at dermoscopy. Dermoscopy is nowadays considered an additional valuable method for skin lesions assessment in general dermatology, following and completing the well-known clinical diagnostic steps, such as medical history and clinical examination. In vivo reflectance confocal microscopy (RCM) is a non-invasive imaging tool able to assess the epidermis and upper dermis producing high resolution (horizontal ∼1.25 μm, vertical ∼5 μm), en face tissue sections used for melanocytic and inflammatory evaluation. In this study, we reported dermoscopic and RCM features about 9 patients affected by subacute and chronic lupus erythematosus retrospectively analyzed.

scholarly journals Isoniazid - induced chronic cutaneous Lupus erythematosus

2016 ◽  
Vol 13 (1) ◽  
pp. 52-56
Author(s):  
A Chiriac ◽  
P Brzezinski ◽  
A E Chiriac ◽  
L Foia ◽  
D Mihaila ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Histopathological Examination ◽  
Cutaneous Lupus Erythematosus ◽  
Clinical Aspects ◽  
Direct Immunofluorescence ◽  
Drug Induced ◽  
Systemic Involvement ◽  
Antituberculosis Therapy ◽  
The Face ◽  
Cutaneous Lupus

A 23-year-old man developed drug-induced chronic cutaneous lupus erythematosus 8 months after isoniazid (INH) therapy for pulmonary tuberculosis. Diagnosis was based on clinical aspects (discoid lesions on the face, erythema, photosensitivity, hyperpigmentation), histopathological examination, along with direct immunofluorescence examination (DIF), the absence of systemic involvement and the routine laboratory parameters, which registered all within normal range. Hydroxychloroquine therapy associated to photo protection and emollients determined the clear up of the facial eruption within six months. Transient residual hyperpigmentation could be noticed 2 months after discontinuation of the treatment. This case illustrates a rare form of drug-induced chronic cutaneous lupus erythematosus developed 2 months after withdrawal of antituberculosis therapy, with excellent results with hydroxychloroquine.NJDVL Vol. 13, No. 1, 2015 Page: 52-56

scholarly journals Tinea incognito: Clinical perspectives of a new imitator

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Samer Dhaher
Keyword(s):  
Lupus Erythematosus ◽  
Skin Diseases ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Systemic Steroid ◽  
Discoid Lupus Erythematosus ◽  
Wide Range ◽  
The Face ◽  
Tinea Incognito ◽  
A Prospective Study

Tinea incognito is a variant of dermatophyte infection of the skin modified by an erroneously applied topical or systemic steroid. Aim of the study: to describe the various clinic-epidemiological aspects of tinea incognito found among our patients. A prospective study was carried out in the Department of Dermatology, Basra Teaching Hospital, Basra, Iraq. The clinical diagnosis was confirmed by mycological tests. Clinical data were described in more detail and the lesions were classified according to the site, shape, and extent. Ninety cases of tinea incognito were seen, median age was 34years. The initial inaccurate diagnoses were eczema in 60 patients (67%), intertrigo in 16 (18 %) and psoriasis in 14 (15%) patients. The type of topical drugs applied was topical corticosteroid (potent and fluorinated) in most cases (54.4%), fixed drug combination creams in 36.6% and a topical calcineurin inhibitor in 5.5%. Commonly presented as acute eczema-like, on hands and trunk, discoid lupus erythematosus-like lesions on the face and psoriasiform lesions on the scalp. Due to the wide range of clinical manifestations, tinea incognito imitates many skin diseases and should, therefore, be considered in any chronic, erythematous, scaly skin lesions not responding to topical treatment.

Periorbital erythema and swelling as a presenting sign of lupus erythematosus in tertiary referral centers and literature review

Lupus ◽  
2018 ◽  
Vol 27 (11) ◽  
pp. 1828-1837 ◽  
Author(s):  
MY Wu ◽  
CH Wang ◽  
CY Ng ◽  
TT Kuo ◽  
YC Chang ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Histopathological Examination ◽  
Cutaneous Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Upper Eyelid ◽  
Negative Results ◽  
Medical Centers ◽  
Positive Rate ◽  
Clinical Awareness ◽  
Dermatologic Manifestations

Background Cutaneous lupus erythematosus (CLE) includes a broad range of dermatologic manifestations. Periorbital involvement, however, is a relatively rare clinical presentation of CLE. Objectives This clinical study aimed to investigate the characteristics of this unique presentation of CLE in tertiary medical centers. Methods We enrolled patients with periorbital erythema and swelling as the presenting sign of lupus erythematosus, from January 2003 to November 2017, using the data of 553 pathologically proven CLE cases from the registration database of the Chang Gung Memorial Hospitals in Taiwan. Results We enrolled a total of 25 patients. The mean age was 46.7 years and 68% of the patients were female. Most of the patients (84.0%) presented with unilateral involvement, with the left orbit involved in 15 patients (60%); the upper eyelid was the most frequently involved (72%). Mean duration between the onset of clinical manifestations and the diagnosis of CLE was approximately 59 weeks. Nineteen patients had been previously misdiagnosed. All patients had features compatible with CLE on histopathological examination. In contrast, laboratory analysis of the autoimmune profile often revealed negative results, including those for antinuclear antibodies (25%). Notably, anti-SSA/SSB (45.5%) showed the highest positive rate. During follow-up, six patients developed systemic lupus erythematosus (SLE) and two patients developed Sjögren syndrome. Conclusions The diagnosis of CLE presenting as periorbital erythema and swelling is often delayed because of clinical mimicry and the high proportion of negative results on autoantibody tests. Increased clinical suspicion and prompt histopathological examination are crucial for early diagnosis. Moreover, one-fourth of the patients ultimately developed SLE, which highlights the importance of clinical awareness.

CUTANEOUS LUPUS ERYTHEMATOSUS: DIRECT IMMUNOFLUORESCENCE AND EPIDERMAL BASAL MEMBRANE STUDY

1992 ◽  
Vol 31 (4) ◽  
pp. 260-264 ◽  
Author(s):  
SOLEDAD A. SUGAI ◽  
ANDREA B. GERBASE ◽  
SELMA S. CERNEA ◽  
MIRIAN N. SOTTO ◽  
ZILDA N.P. OLIVEIRA ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Cutaneous Lupus Erythematosus ◽  
Basal Membrane ◽  
Direct Immunofluorescence ◽  
Cutaneous Lupus

scholarly journals Discoid lupus erythematosus skin lesion distribution and characteristics in Black patients: a retrospective cohort study

2021 ◽  
Vol 8 (1) ◽  
pp. e000514
Author(s):  
Adrienne K Joseph ◽  
Brandon Windsor ◽  
Linda S Hynan ◽  
Benjamin F Chong
Keyword(s):  
Cohort Study ◽  
Lupus Erythematosus ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Univariate Analysis ◽  
Cutaneous Lupus Erythematosus ◽  
Discoid Lupus Erythematosus ◽  
Anatomical Location ◽  
Scarring Alopecia ◽  
Black Patients

ObjectiveEpidemiological studies have shown that discoid lupus erythematosus (DLE) has a higher incidence and prevalence in racial/ethnic minority groups, particularly Black individuals. The objective of this retrospective cohort study was to identify the differences in DLE lesion distribution and characteristics in Black individuals compared with non-Black individuals.Methods183 patients with DLE (112 Black patients and 71 non-Black patients) with a reported race/ethnicity and Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) scores were included in this retrospective cohort study. Univariate analysis was performed to determine significant differences in demographic data, clinical characteristics, DLE lesion distribution and DLE lesion characteristics in Black and non-Black patients with DLE. Multivariable logistic regression was preformed to determine significant predictors of DLE lesion location and characteristics.ResultsBlack patients with DLE had worse baseline CLASI damage scores compared with non-Black patients with DLE (median (IQR): 10.0 (6.0–14.5) vs 6.0 (3.0–10.0), p<0.001) and had 48.9 greater odds of dyspigmentation in any anatomical location (p<0.001). Black patients had 2.54 greater odds of having scalp involvement (p=0.015) and 1.97 greater odds of having ear involvement (p=0.032) compared with non-Black patients. Black patients also had greater odds of scalp dyspigmentation (OR=5.85, p<0.001), ear dyspigmentation (OR=2.89, p=0.001) and scarring alopecia (OR=3.00, p=0.001) compared with non-Black patients.ConclusionsSigns of disease damage, particularly ear dyspigmentation, scalp dyspigmentation and scarring alopecia, can more frequently affect Black patients with DLE. Recognising differences in clinical presentation of DLE among Black patients can assist future efforts with understanding biological, cultural, psychosocial and systemic factors that influence DLE presentation and outcomes in Black patients and may guide clinicians when counselling Black patients.

scholarly journals Clinical profile of cutaneous manifestations of connective tissue diseases in North-East India

2021 ◽  
Vol 7 (5) ◽  
pp. 702
Author(s):  
Deepa Mala Subba ◽  
Nandakishore Thokchom ◽  
Linda Kongbam ◽  
Erika Salam ◽  
Deepa Yumnam
Keyword(s):  
Connective Tissue ◽  
Lupus Erythematosus ◽  
Cutaneous Lupus Erythematosus ◽  
Connective Tissue Diseases ◽  
Skin Lesions ◽  
Discoid Lupus Erythematosus ◽  
Serological Tests ◽  
Cross Sectional ◽  
Cutaneous Manifestations ◽  
North East

<p class="abstract"><strong>Background:</strong> Connective tissue diseases (CTDs) are a heterogeneous group of autoimmune disorders having overlapping clinical features. Skin is often involved and it may be the earliest sign of the disease. This study highlighted the various cutaneous manifestations of common CTDs.</p><p class="abstract"><strong>Methods:</strong> A hospital-based cross-sectional study was carried out for a period of two years in 83 patients with CTDs in dermatology OPD, RIMS, Imphal. Detailed history taking, examination and relevant serological tests were performed.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age was 39.78±17.29 years with female to male ratio of 4.5:1. Majority of the patients had lupus erythematosus (LE) (N=45) followed by systemic sclerosis (SSc) (N=25), rheumatoid arthritis (RA) (N=6), mixed connective tissue disease (MCTD) (N=4) and morphea (N=3). The most common presentation was raised skin lesions (45.8%) followed by Raynaud’s phenomenon (36.1%), photosensitivity (27.7%), skin tightness (26.5%) and joint pain (19.3%). Among LE patients, chronic cutaneous lupus erythematosus (CCLE) was the commonest variant and localised discoid lupus erythematosus (DLE) (22.9%) was the commonest presentation followed by malar rash and annular subacute lupus erythematosus (SCLE). Skin induration, microstomia and sclerodactyly were seen in most patients of SSc. Antinuclear antibodies were positive in 89.1% of patients. Anti-dsDNA and anti-Sm antibodies were positive in 62.2% and 33.3% of LE patients, anti-Scl 70 antibody was positive in 68% of SSc patients.</p><p class="abstract"><strong>Conclusions:</strong> CTDs are rare but potentially life-threatening. Proper understanding of the spectrum of cutaneous manifestations of CTDs is therefore necessary for early diagnosis and efficient management.</p>

Sign in / Sign up

Export Citation Format

Share Document