[Subacute cutaneous lupus gyratus repens]

Abstract

Background: Erythema gyratum repens is a rare paraneoplastic eruption. To date, only sixty have appeared in the literature. We report a patient with clinical and histological cutaneous subacute lupus and typical erythema gyratum repens.

Case report: A 86-year-old woman presented with a 2-month history erythematous patches, confined mainly to the trunk, arms, thighs and the face. Cutaneous biopsy was compatible with cutaneous subacute lupus. After 4 weeks of hydroxychloroquine treatment, physical examination revealed erythematous, concentric, serpiginous and scaly bands on the trunk. Erythematous patches persisted on the limbs and the face. Physical examination and investigations in search of an internal malignancy were negative. All cutaneous lesions resolved after three months of chloroquine and dapsone treatment.

Discussion: Fourteen cases of erythema gyratum repens have been reported unassociated with underlying malignancy. This eruption usually precedes the occurrence of the neoplasm. Erythema gyratum repens is a migrating gyrate erythema with a serpiginous, concentric appearance creating a wood-grain look in the skin, which is pathognomonic. Histological findings are not specific, showing light parakeratosis and perivascular lymphocytic infiltrate of superficial dermis. Five cases of cutaneous lupus associated with erythema gyratum repens eruption have been reported. Considering the negative check-up in search of internal malignancy on a follow-up period of 20 months, our case is a probably a particular form of subacute lupus.