Discoid Lupus Erythematosus-Associated Cutaneous Squamous Cell Carcinoma in Systemic Lupus Erythematosus

Melikoğlu, Meltem Alkan; Melikoğlu, Mehmet; Demirci, Elif; Barin, Ensar Zafer

doi:10.5152/eurasianjmed.2022.21062

Cited by 5 publications

(6 citation statements)

References 8 publications

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“…Lymph node biopsy in lupus commonly shows reactive follicular hyperplasia with or without atypical cells and is considered as a nonspecific finding. 7 Coagulative necrosis with hematoxylin bodies typical of SLE is rarely seen. 7 A classification of the patterns of lymph node lesions in SLE, similar to the classes of lupus nephritis has been suggested; however, these types do not seem to be specific enough to establish the diagnosis of SLE.…”

Section: Discussionmentioning

confidence: 99%

Unusual presentation and rare association of pediatric lupus

Krishna

Joseph

Krishnan

et al. 2023

Int J Contemp Pediatr

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Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune inflammatory disorder with diverse clinical manifestations which can lead to significant morbidity and mortality. Children and adolescents represent 15% to 20% of all patients with SLE. Childhood onset SLE is a rare disease with a prevalence of 3.5 to 8.8 per one lakh children. Localized or generalized lymphadenopathy may be an uncommon presenting feature of SLE. None of the classification criteria for SLE include lymphadenopathy as a criterion including the latest 2019 American college of rheumatology (ACR) / European league against rheumatism (EULAR) criteria. Nine-year-old female child presented with history of swelling on both sides of neck associated with fever and easy fatiguability for 2 months. Clinical examination revealed significant bilateral cervical and axillary lymph nodes with hepatomegaly. Excision biopsy of lymph node was suggestive of Kikuchi Fujimoto disease (KFD). As rare association of KFD with SLE is well described in literature, despite negative clinical features and laboratory findings of SLE, including an initial negative ANA IF test, we did a repeat ANA IF, complement (C3) level and dsDNA testing, all of which turned out to be positive, confirming the diagnosis of SLE. The child was started on hydroxychloroquine and oral steroids with dramatic response. During steroid tapering she developed a flare needing the addition of azathioprine. Currently she is in remission and is under follow up. Although rare, lupus lymphadenopathy may be a presenting feature of SLE. This can even antecede the diagnosis of SLE by many years, when the presence of auto antibodies or low complement levels are not detected and are associated with higher disease activity. This emphasizes the importance of high index of suspicion of SLE in cases of lymphadenopathy, enabling early diagnosis and management which is essential for preventing morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Unusual presentation and rare association of pediatric lupus

Krishna

Joseph

Krishnan

et al. 2023

Int J Contemp Pediatr

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“…Systemic lupus erythematosus (SLE) is a multisystem disease which has a broad range of manifestations with a clinical course presenting remissions and relapses [ 1 ]. In the management of SLE, the evaluation of its activity is of utmost importance.…”

Section: Highlight Key Pointsmentioning

confidence: 99%

A potential biomarker of disease activity in systemic lupus erythematosus, systemic immune-inflammation index

Akdogan

2024

North Clin Istanbul

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OBJECTIVE Biomarkers using routine laboratory tests accurately presenting systemic lupus erythematosus (SLE) disease activity may have important practical values in clinical settings. The primary purpose of this study was to investigate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII; neutrophil X platelet/lymphocyte) as potential biomarkers of disease activity in cases with SLE. METHODS In this case-control observational study, cases with SLE and demographically similar healthy controls were included. For clinical evaluation demographic features, disease duration and drugs were recorded. SLE clinical disease activity was assessed with SLEDAI scores. For laboratory assessments; erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and C3-C4 levels and anti-dsDNA positivity were recorded. Based on the simultaneous complete blood count (CBC) of the participants NLR, PLR and SII were calculated. The correlation between clinical and laboratory data was analyzed. RESULTS 68 cases with SLE (64 women, 8 men) and 69 controls (65 women, 4 men) were included in this investigation. The demographic features of the cases and controls were similar. ESR, CRP, NLR, PLR and SII scores were statistically higher in cases with SLE than controls (p<0.000). Statistically significant positive correlations between SLEDAI and NLR, PLR and SII scores were demonstrated (p=0.01, r=0.505; 0.414; 0.698, respectively). We determined a cut-off value of SII as 681,3 presenting 77% sensitivity and 76% specificity to discriminate no-mild disease activity and moderate-higher SLE disease activity status. The SII cut-off value was determined as 681,3 presenting 77% sensitivity and 76% specificity (p<0.000, and AUC=0.930). CONCLUSION CBC indices were shown to be higher in cases with SLE than healthy controls in our study. By presenting a strong correlation with disease activity and discriminating ability of disease status, SII might serve as a biomarker supporting clinical evaluation in SLE.

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“…Given the clinical overlap between SLE and multicentric CD (MCD), having overlapping histopathological features presents a challenge to making an accurate diagnosis. Similarly, an important differential diagnosis is Kikuchi-Fujimoto disease, another condition with histological presentation highly reminiscent of SLE that can be found in association with SLE [ 22–24 ].…”

Section: Rheumatologic Diseases With Lymphadenopathymentioning

confidence: 99%

Lymphadenopathy in the rheumatology practice: a pragmatic approach

Rodolfi,

Della-Torre,

Bongiovanni

et al. 2023

Rheumatology

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Lymphadenopathy is a common clinical finding and diagnostic challenge within general medicine and rheumatology practice. It may represent a primary manifestation of an underlying immune-mediated disease or indicate an infectious or neoplastic complication requiring differing management. Evaluating lymphadenopathy is of particular relevance in rheumatology, given that lymph node enlargement is a common finding within the clinical spectrum of several well-known rheumatologic disorders including RA, SLE and SS. In addition, lymphadenopathy represents a hallmark manifestation of rare immunological diseases such as Castleman disease and IgG4-related disease that must be considered in the differential diagnosis because effective targeted treatments can now impact the prognosis of these conditions. In this review we present an overview of the clinical significance of lymphadenopathy in common and rare rheumatologic diseases and propose a practical approach to lymphadenopathy in the rheumatology practice. Differential diagnosis of Castleman disease and therapeutic options for this condition of increasing rheumatologic interest will be discussed in detail.

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Discoid Lupus Erythematosus-Associated Cutaneous Squamous Cell Carcinoma in Systemic Lupus Erythematosus

Cited by 5 publications

References 8 publications

Unusual presentation and rare association of pediatric lupus

Unusual presentation and rare association of pediatric lupus

A potential biomarker of disease activity in systemic lupus erythematosus, systemic immune-inflammation index

Lymphadenopathy in the rheumatology practice: a pragmatic approach

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