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Review
. 2016 Apr;95(16):e3429.
doi: 10.1097/MD.0000000000003429.

Lupus Panniculitis as an Initial Manifestation of Systemic Lupus Erythematosus: A Case Report

Yu-Kun Zhao  1 , Fang Wang, Wen-Na Chen, Rui Xu, Zhuo Wang, Yuan-Wen Jiang, Di-Qing Luo, Jian-De Han
Affiliations
Review

Lupus Panniculitis as an Initial Manifestation of Systemic Lupus Erythematosus: A Case Report

Yu-Kun Zhao et al. Medicine (Baltimore). 2016 Apr.

Abstract

Lupus erythematosus panniculitis (LEP) is a variant of chronic cutaneous lupus erythematosus (CCLE). Reported cases of LEP lesions before the diagnosis of systemic lupus erythematosus (SLE) were very rare; only 9 cases have been reported, to the best of our knowledge. We now describe the case of a 19-year-old male patient, with an overall review of the English literature. In the earliest stage of the present case, nodules and ulcers involved his left leg and face, with no other accompanied symptoms. The skin lesions disappeared after treatment with methylprednisolone, 16 mg/d for 1 month. Seven months after discontinuing methylprednisolone, the cutaneous nodules and ulcers on his back recurred and were accompanied by fever, hair loss, and polyarthritis. Blood tests revealed leucopenia, positive antinuclear antibody and Smith antibody, and proteinuria. Histopathological findings were most consistent with LEP. This was followed sequentially by the diagnosis of SLE. The patient improved again after treatment with methylprednisolone and cyclophosphamide.Patients with LEP should have regular follow-ups because the development of SLE is possible. Early diagnosis and proper treatment is pivotal to improve the prognosis of such patients.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
(A) Two red subcutaneous nodules (red arrows) and multiple well-defined deep ulcers on the patient's back. (B) After 2 months of treatment, the ulcers and nodules had substantially improved.
FIGURE 2
FIGURE 2
(A) Perivascular and periadnexal lymphocytic infiltrations from the upper dermis to the deep dermis. (B) A profile of lymphocytic mixed panniculitis with hyaline necrosis (red arrows) of the subcutaneous fat. (C) Lymphocytic vasculitis in the interlobular septa. (D) Fibrin thrombosis in the interlobular septa (red arrows; the area squared in black is magnified at the bottom right). (A, original magnification 40×; B, original magnification 100×; C, original magnification 400×; D, original magnification 100×, hematoxylin-eosin).
See this image and copyright information in PMC

References

    1. Arai S, Katsuoka K. Clinical entity of Lupus erythematosus panniculitis/lupus erythematosus profundus. Autoimmun Rev 2009; 8:449–452. - PubMed
    1. Park HS, Choi JW, Kim BK, et al. Lupus erythematosus panniculitis: clinicopathological, immunophenotypic, and molecular studies. Am J Dermatopathol 2010; 32:24–30. - PubMed
    1. Ng PP, Tan SH, Tan T. Lupus erythematosus panniculitis: a clinicopathologic study. Int J Dermatol 2002; 41:488–490. - PubMed
    1. Martens PB, Moder KG, Ahmed I. Lupus panniculitis: clinical perspectives from a case series. J Rheumatol 1999; 26:68–72. - PubMed
    1. Diaz-Jouanen E, DeHoratius RJ, Alarcon-Segovia D, et al. Systemic lupus erythematosus presenting as panniculitis (lupus profundus). Ann Intern Mes 1975; 82:376–379. - PubMed