Lupus erythematosus panniculitis with morphea-like lesions

Abstract

A 22-year-old female with morphea-like lesions, deep subcutaneous nodules and lipoatrophic areas of the skin on lateral aspects of the upper arms, on the breasts and on the buttocks is described. In 1990 a biopsy specimen obtained from a subcutaneous nodule showed hyaline necrosis of fat tissue; there were no epidermal changes. Direct immunofluorescence revealed granular deposits of IgM at the dermo-epidermal junction of the skin overlying the subcutaneous nodule. In a biopsy specimen taken at the onset of the disease in 1988, hyaline sclerosis of the deep dermis, follicular hyperkeratosis and vacuolar degeneration in the epidermis were described. There was weak positivity for antinuclear antibodies. The diagnosis of lupus erythematosus panniculitis (LEP) was made. Administration of chloroquine resulted in complete clearing of nodules in 3 months. The reported case demonstrates the difficulties in establishing the diagnosis of LEP in patients who present with subcutaneous disease, morphea-like lesions and who do not have other clinical or laboratory evidence of lupus erythematosus. The differential diagnosis of LEP and deep morphea is discussed.

Sclerodermic Linear Lupus Panniculitis: Report of Two Cases

“…The latter may be considered, in our opinion, as the first reported case of sclerodermic linear LEP. To the best of our knowledge, only another patient having LEP with morphea-like lesions, in whom however the linear configuration was lacking, has subsequently been described [6]. …”

“…A linear configuration of LEP has very rarely been described [1,2,3,4]. On the other hand, rare descriptions of the coexistence of cutaneous LE and localized scleroderma or morphea have been reported [5, 6]. …”

Sclerodermiform linear lupus erythematosus: A distinct entity or coexistence of two autoimmune diseases?

“…1,2 The coexistence of features of CCLE and scleroderma in the same skin lesions is very infrequent and has only been reported in 3 patients. [3][4][5] The name ''sclerodermiform linear lupus erythematosus'' (SLLE) has been suggested for this disorder. 3 We present a case report of clinical and histologic features suggestive of this exceedingly rare condition.…”

Intravenous Immunoglobulin in Lupus Panniculitis

“…In addition to the classical presentation of LEP as deep dermal or subcutaneous nodules, linear and morphea-like lesions and Parry Romberg syndrome (periorbital erythema with facial hemiatrophy and endopthalmos) have also been reported [23,[30][31][32]. Associated with irreversible lipoatrophy and extensive cosmetic disfigurement, major depression can be present.…”