A comedonal variant of chronic cutaneous lupus erythematosus: Case report and literature review

Comedonal variant of chronic cutaneous lupus erythematosus causing mutilation of the earlobe

“…We add to the existing literature on this less well-known subtype of CCLE. We hope our article adds further value to the case report by Droesch and Magro, 1 promoting caution regarding acnelike lesions that are not responsive to acne therapy, especially in young women, because a comedonal CCLE may be the underlying cause of the lesions and may become irreversibly mutilating and even life threatening in concomitantly systemic cases if misdiagnosed and untreated.…”

“…To the Editor: We read with interest the article by Droesch and Magro 1 reporting on the comedonal variant of chronic cutaneous lupus erythematosus (CCLE).…”

“…Comedonal CCLE is an exceedingly rare but documented variant of CCLE: only 13 cases have been reported in the literature,70% of which occurred in women with a mean age of 32 years. 1 , 2 , 3 , 4 , 5 Concurrent systemic erythematous lupus was reported in 4 cases. 1 , 4 , 5 Comedonal CCLE can be mistaken for benign dermatologic conditions such as nevus comedonicus, Favre-Racouchot disease, agminate lichen follicularis with cysts and comedones, and especially acne vulgaris.…”

“… 1 , 2 , 3 , 4 , 5 Concurrent systemic erythematous lupus was reported in 4 cases. 1 , 4 , 5 Comedonal CCLE can be mistaken for benign dermatologic conditions such as nevus comedonicus, Favre-Racouchot disease, agminate lichen follicularis with cysts and comedones, and especially acne vulgaris. 3 , 6 However, unlike these benign entities, CCLE bears a highly destructive potential, with atrophic scarring and even mutilations occurring in untreated disease, as in our case.…”

“…Also, 31% of individuals with comedonal CCLE have concomitant systemic erythematous lupus, with a significant potential morbidity associated with diagnostic and therapeutic delay. 1 , 4 , 5…”