Lupus tumidus is considered a rare subtype of chronic cutaneous lupus erythematosus, characterized by erythema and bright urticarial erythematous- violaceous. Tumid lupus erythematosus (TLE), also known as lupus erythematosus tumidus, is a highly photosensitive form of cutaneous lupus erythematosus (cutaneous. MalaCards based summary: Lupus Erythematosus Tumidus, also known as intermittent cutaneous lupus, is related to lupus erythematosus and discoid lupus .
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A complete resolution of the skin lesions was seen after systemic therapy with antimalarials and, in some cases, with local corticosteroids or spontaneously without any treatment.
Hypopigmentation, frequently evident in patients with SCLE after the active phase with erythema and scaling, has never been detected in patients with LET.
Test areas were evaluated until specific lesions appeared for tmidus to 4 weeks after the last irradiation. Criteria for positive provocative phototest results required that induced lesions clinically resembled LE, histopathological findings were compatible with LE, and skin lesions developed slowly and persisted for several days or weeks in contrast to other photodermatoses such as PLE.
Photograph of face showing blanching inflamed plaques with raised borders and coalescing of lesions. To assess whether the age at onset of LET differs significantly between male and female patients, t test was performed.
Histopathological features colloidal iron staining of lupus erythematosus tumidus. J Am Acad Dermatol.
Pathologic study revealed a moderate predominantly perivascular lymphocytic infiltrate not affecting the blood vessels in the papillary dermis and superficial and deep reticular dermis Figure 3. Contin Educ Fam Physician. In the following years, 3 additional patients with similar skin lesions were described by the same authors 7 – 9 ; however, the next case reports of LET were not mentioned until in the German and the French literature.
Copyright American Medical Association. Treatment is based on photoprotection, topical corticosteroids and antimalarials. Chronic cutaneous lupus erythematosus. Andrews’ Diseases of the Skin: You can help Wikipedia by expanding it. Total hemolytic complement CH50 was measured using the photometer, and lupus anticoagulant was evaluated by kaolin clotting time KCT. They involve sun-exposed areas eg, face, upper back, V area of the neck, extensor aspects of the arms, and shoulders ; spare the knuckles, inner aspect of the arms, and axillae; and have never been detected below the waist Figure 2.
We report two cases of lupus tumidus, which deserve attention for their low frequency in the literature, in addition to their relevance as a differential diagnosis among dermatologic disorders. Systemic corticosteroids or immunosuppressants were only temporarily necessary in 2 patients. Patients, materials, and methods. Purchase access Subscribe to JN Learning tumidjs one year.
Lupus Erythematosus Tumidus: A Unique Disease Entity
However, epidermal involvement usually was utmidus found, and smudging of the dermoepidermal junction was only occasionally detected. DermNet NZ does luous provide an online consultation service. Active and burned-out disease can lead to social tuumidus and depression. The main differential diagnoses are polymorphous light eruption, Jessner’s lymphocytic infiltration of the skin, reticular erythematous mucinosis, and pseudolymphoma.
A general stepwise approach to treatment can be partially extrapolated from Kuhn, et al’s, series of 40 patients from a progressively more systemic and toxic lineation; sunscreen sun exposure avoidancetopical steroid treatment, antimalarial therapy, followed by systemic steroids, and other immunosuppressants. Lupus erythematosus tumidus, a neglected subset of cutaneous lupus erythematosus. Development of characteristic skin lesions are seen 1 week after UV-A irradiation for 3 consecutive days.
Once a lesion has developed, it can disappear spontaneously within a few days or weeks, even if the disease recurs tuumidus in patients with LET. It is more prevalent in patients with skin of colour, who are at greater risk of postinflammatory hyperpigmentation and hypertrophic scarring.
Treatment There are few evidence-based pharmacologic pupus for LET beyond case reports and series. Other distinguishing histologic features of the major clinical variants of tumids erythematosus involving the skin are noted in Table 1. Histopathological features hematoxylin-eosin staining of lupus erythematosus tumidus. Treatment for cutaneous and systemic LE may include:.
A punch biopsy of right upper extremity revealing a superficial and deep periadnexal and interstitial infiltrate composed of lymphocytes, histiocytes, plasma cells, and a few scattered neutrophils.
This case exemplifies the need for complete disease characterization, evidence-based treatment, and a multidisciplinary approach. Biopsies of the skin on the left frontal region and of the left nasolabial sulcus suggested the diagnosis of lupus tumidus. LE nonspecific cutaneous features are most often associated with SLE. Skin lesions are edematous, urticarialike annular papules and plaques. Interestingly, the mainstay of treatment for LET, in the limited case reports and series that exist, is with antimalarial drugs, which our patient had already been taking for SLE.
Fisher exact test was used to determine the significance.
Lupus tumidus: a report of two cases
Lupus erythematosus tumidus LET is a photosensitive skin disease characterized by succulent, edematous, and non-scarring plaques. Positive results of provocative phototesting of lupus erythematosus tumidus. There are few evidence-based pharmacologic treatments for LET beyond case reports and series. Lupus erythematosus LE is an autoimmune connective tissue disorder that can affect one or several organs.
Because of the rapid and effective improvement of the skin lesions after treatment with antimalarials, systemic corticosteroids or immunosuppressants were temporarily necessary in only 2 patients.