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Lim S, Sidky L, Eliott E, Cobos G. A gyrate pattern of discoid lupus erythematosus. J Dermatol 2024; 51:e106-e107. [PMID: 38433363 DOI: 10.1111/1346-8138.17135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Subin Lim
- Department of Dermatology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Lillian Sidky
- Department of Dermatology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Erika Eliott
- Department of Dermatology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Gabriela Cobos
- Department of Dermatology, Tufts Medical Center, Boston, Massachusetts, USA
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Affiliation(s)
- Fatima Azzahra El Gaitibi
- Department of Dermatology, Mohammed V University in Rabat, Ibn Sina University Hospital, Rabat, Morocco
- Correspondence to: Fatima Azzahra El Gaitibi, MD, Ibn Sina University Hospital, Al Mfaddal Cherkaoui Street, 10080 Rabat, Morocco.
| | - Jihane Belcadi
- Department of Dermatology, Mohammed V University in Rabat, Ibn Sina University Hospital, Rabat, Morocco
| | - Sara Oulad Ali
- Department of Dermatology, Mohammed V University in Rabat, Ibn Sina University Hospital, Rabat, Morocco
| | - Kaoutar Znati
- Department of Histopathology, Mohammed V University in Rabat, Ibn Sina University Hospital, Rabat, Morocco
| | - Karima Senouci
- Department of Dermatology, Mohammed V University in Rabat, Ibn Sina University Hospital, Rabat, Morocco
| | - Nadia Ismaili
- Department of Dermatology, Mohammed V University in Rabat, Ibn Sina University Hospital, Rabat, Morocco
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Liu E, Daze RP, Moon S. Tumid Lupus Erythematosus: A Rare and Distinctive Variant of Cutaneous Lupus Erythematosus Masquerading as Urticarial Vasculitis. Cureus 2020; 12:e8305. [PMID: 32607289 PMCID: PMC7320659 DOI: 10.7759/cureus.8305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/26/2020] [Indexed: 01/03/2023] Open
Abstract
Tumid lupus erythematosus (TLE) is a rare form of chronic cutaneous lupus that has triggered much debate regarding its clinical and histopathological features. It has been classically defined as annular erythematous, succulent, plaques involving the face and trunk that typically are devoid of any papulosquamous features such as scale and follicular plugging. These lesions are a clinical mimicker of other urticarial lesions such as urticarial vasculitis and lymphocytic infiltrate of Jessner. We report a case of TLE presenting in a 49-year-old Caucasian female whose initial clinical presentation was concerning for urticarial vasculitis due to presence of urticarial-like lesions present for approximately three months. Laboratory studies and histopathological correlations confirmed the diagnosis of TLE and the patient was successfully treated with topical corticosteroids.
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Affiliation(s)
- Evan Liu
- Dermatology, Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, Largo, USA
| | | | - Summer Moon
- Dermatology, Largo Medical Center, Largo, USA
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Abstract
The occurrence of Tolosa-Hunt syndrome (THS) in the setting of discoid lupus erythematosus (DLE) has not been previously reported. We report a case of a 55-year-old Chinese man with established cutaneous lupus who presented with 1 week of worsening blurry vision and ptosis of the left eye with severe headache 2 weeks prior to presentation. His cranial nerve examination was significant for left afferent pupillary defect, red desaturation, ptosis, and oculomotor nerve palsy. He also presented with active DLE lesions. Magnetic resonance imaging brain demonstrated asymmetric thickening and enhancement of the left cavernous sinus consistent with THS. After a 4-week gradual steroid taper his ophthalmoplegia resolved. The unusual occurrence of THS and DLE prompts consideration of nonsystemic autoimmune disorders in diagnosis of THS.
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Affiliation(s)
- Amy W Yu
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Eli J Finkelsztein
- Department of Internal Medicine, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
| | - Natalie T Cheng
- Department of Neurosciences, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
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Affiliation(s)
- Irina Lerman
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Ritesh Agnihothri
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York
| | - Glynis A Scott
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York
| | - Christopher T Richardson
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York.,Division of Allergy, Immunology and Rheumatology, University of Rochester Medical Center, Rochester, New York
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Affiliation(s)
- Caren Droesch
- Department of Dermatology, New York Presbyterian and Weill Cornell Medical College, New York, New York
| | - Cynthia Magro
- Department of Dermatology, New York Presbyterian and Weill Cornell Medical College, New York, New York.,Department of Dermatopathology, New York Presbyterian and Weill Cornell Medical College, New York, New York
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Abstract
Linear lesions following the lines of Blaschko of chronic cutaneous lupus erythematosus is a highly unusual variant of cutaneous lupus, particularly in adult. The lesions are restricted to one anatomical site with facial predilection in most of the reported cases. We herein, report a case of chronic cutaneous lupus erythematosus due to rarity of presentation and later age of onset.
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Affiliation(s)
- Manju Meena
- Department of Dermatology, RNT Medical College, Udaipur, Rajasthan, India
| | - Manisha Balai
- Department of Dermatology, RNT Medical College, Udaipur, Rajasthan, India
| | - Sharad Mehta
- Department of Dermatology, RNT Medical College, Udaipur, Rajasthan, India
| | - Garima Bharti
- Department of Dermatology, RNT Medical College, Udaipur, Rajasthan, India
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Samotij D, Szczęch J, Werth VP, Furukawa F, Kuhn A, Szepietowski JC, Reich A. Disease severity and prophylactic measures in patients with cutaneous lupus erythematosus: results of a worldwide questionnaire-based study. Postepy Dermatol Alergol 2018; 35:192-8. [PMID: 29760621 DOI: 10.5114/ada.2018.75242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 01/29/2017] [Indexed: 01/17/2023] Open
Abstract
Introduction Due to a wide array of dermatologic manifestations, assessment of disease severity in cutaneous lupus erythematosus (CLE) remains challenging. Given a need for some standardization in this field, we conducted a worldwide questionnaire-based study among physicians experienced in CLE management. Aim We asked about CLE assessment, their prophylactic measures advised to patients, and treatment recommendations. Material and methods A total of 83 completed questionnaires were received. Participating physicians recommended assessing disease severity at each patient’s visit (39.1%), monthly (4.9%) or at least every third month (17.3%). Almost half of the responding physicians (47.0%) waited 2–3 months before identifying a specific treatment option as not effective. Results The vast part of the participants informed their patients about of the risks of sun exposure and advised adequate preventive measures. Smoking was less frequently a matter of discussion between physicians and their patients. Recommendations for the timing of CLE severity assessment likely depends on disease severity and the type of therapeutic intervention. Conclusions Proper patient education about effective prophylactic measures should be included during routine CLE patient consultations.
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Sáenz-Corral CI, Vega-Memíje ME, Martínez-Luna E, Cuevas-González JC, Rodríguez-Carreón AA, de la Rosa JJBYG, Del Muro FDJT, Avalos-Díaz E. Apoptosis in chronic cutaneous lupus erythematosus, discoid lupus, and lupus profundus. Int J Clin Exp Pathol 2015; 8:7260-7265. [PMID: 26261624 PMCID: PMC4525958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 05/21/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Lupus erythematosus is a multisystemic disease that is characterized by autoantibody production and immune complex deposition in such tissues as the mucosa, joints, the central nervous system, and skin. Cutaneous lupus erythematosus is categorized as acute, subacute, and chronic. Chronic cutaneous lupus erythematosus comprises discoid lupus erythematosus (DLE) and lupus profundus (LP). AIM To analyze the expression of proapoptotic molecules in patients with lupus erythematosus discoid and lupus profundus. MATERIAL AND METHODS Descriptive study, the study groups comprised 10 cases of LP and 10 cases of DLE, and a control. Skin samples of cases and controls were processed for immunohistochemistry and by TUNEL technique. The database and statistical analysis was performed (statistical test X(2)) SPSS (Chicago, IL, USA). RESULTS Apoptotic features were broadly distributed along the skin biopsies in epidermal keratinocytes as well as at dermis. By immunohistochemistry the expression of Fas receptor and Fas-L was higher in the skin of lupus patients compared with controls. We also noted differences in Fas-L, -Fas, and -Bax proteins expression intensity in discoid lupus erythematosus patients in the epidermis, and hair follicles. CONCLUSIONS Fas and Fas-L are expressed similarly in LP and DLE.
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Affiliation(s)
| | | | | | | | | | | | | | - Esperanza Avalos-Díaz
- Laboratory of Immunology and Molecular Biology, UABE, Universidad Autónoma de Zacatecas Zacatecas, Zac, Mexico
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Abstract
Lupus erythematosus (LE) is a chronic, autoimmune, multisystem disease that displays many diverse symptoms in which localized cutaneous LE (CLE) is on one end of the spectrum and severe systemic LE (SLE) on the other end. The underlying cause of LE is unknown but the etiology is thought to be multifactorial and polygenic. CLE is a disfiguring, chronic skin disease, with a significant impact on the patients’ everyday life. CLE are further divided into three main subsets: Acute CLE (ACLE), subacute CLE (SCLE) and chronic CLE (CCLE), where classic discoid LE (DLE) is the most common form. These subsets are defined by clinical symptoms, average duration of symptoms and histological and serological findings, although, the three subtypes can have overlapping clinical features. CLE patients display well-defined skin lesions, often in sun-exposed areas. The disease often has a chronic and relapsing course that can be induced or aggravated by UV light. It is important to confirm a CLE diagnosis histopathologically by a biopsy and in that there are several differential diagnoses and because CLE is a chronic disease in which regular follow-up is important and systemic treatment is sometimes indicated.
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Affiliation(s)
- Carina M Grönhagen
- Institute of Environmental Medicine, Unit of Occupational and Environmental Dermatology, Karolinska Institutet, Stockholm, Sweden
| | - Filippa Nyberg
- Uppsala University Hospital, Department of Dermatology, Uppsala, Sweden
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