Comedonic lupus, a rare variant of chronic cutaneous lupus erythematosus (CCLE): case series and literature review.

BACKGROUND: Cutaneous lupus erythematosus (CLE) is an autoimmune disease with several clinical presentations. The chronic form predominantly presents as discoid rashes but may present with less common morphological findings that can sometimes make diagnosis difficult. Comedonic lupus is a rare and underdiagnosed variant, with unknown etiology and still poorly defined treatment. METHODS: The report illustrates a series of five cases of patients diagnosed with comedonic lupus, and it reviews 18 cases previously published in the literature. RESULTS: The clinical presentation is of comedonal lesions, mostly located on the face, making a differential diagnosis with other benign conditions such as acne vulgaris, Favre-Racouchot syndrome, and syringoma, emphasizing the importance of clinical practice and histopathology for diagnostic confirmation. CONCLUSIONS: There is scarcity in the literature regarding the condition and therapeutic possibilities for these cases of comedonic lupus.

Dowling-Degos disease: classic clinical and histopathological presentation.

Dowling-Degos disease (DDD) is a rare genetic disease of the skin (reticulate pigmented anomaly), clinically characterized by flexural brown pigmented reticulate macules, comedo-like papules on the back, neck and pitted perioral or facial scars. We present the case of a 51 year-old man with macrocomedo-like lesions, pitted scars, cysts, hyperpigmented macules in his back, chest, axillae, neck, groin and face. The patient reported having two children, three brothers and a father with a similar condition. The histopathology of the skin biopsies was very characteristic of Dowling-Degos disease, showing dilated follicular, fingerlike projections called rete ridges (dermal pegs), with thinning of the suprapapillary plates, resulting in an "antler-like" pattern and increased pigmentation of the basal layer.

Doença de Dowling-Degos: apresentação clínica e histopatológica clássica / Dowling-Degos disease: classic clinical and histopathological presentation

A doença de Dowling-Degos é uma genodermatose rara que consiste numa desordem pigmentar reticulada. Caracteriza-se pela presença de máculas hiperpigmentadas nas regiões flexurais com distribuição em rede; lesões tipo comedão no dorso e na região cervical; e cicatrizes cribriformes na face, particularmente periorais. Apresentamos um caso de um paciente de 51 anos, masculino, com lesões tipo macrocomedões, cicatrizes cribriformes, cistos e máculas hipercrômicas no dorso, tórax anterior, axilas, pescoço, região genital e face. Relatava ter dois filhos, três irmãos e o pai com quadro semelhante. As biópsias de pele foram características da doença de Dowling-Degos, mostrando dilatação folicular, epiderme digitiforme, com áreas de aspecto de "chifre de veado" e focos de hiperpigmentação da camada basal.

Dowling-Degos disease (DDD) is a rare genetic disease of the skin (reticulate pigmented anomaly), clinically characterized by flexural brown pigmented reticulate macules, comedo-like papules on the back, neck and pitted perioral or facial scars. We present the case of a 51 year-old man with macrocomedo-like lesions, pitted scars, cysts, hyperpigmented macules in his back, chest, axillae, neck, groin and face. The patient reported having two children, three brothers and a father with a similar condition. The histopathology of the skin biopsies was very characteristic of Dowling-Degos disease, showing dilated follicular, fingerlike projections called rete ridges (dermal pegs), with thinning of the suprapapillary plates, resulting in an "antler-like" pattern and increased pigmentation of the basal layer.

Case for diagnosis

Paciente de 43 anos de idade, sexo feminino, branca, casada, roupeira, natural do Rio de Janeiro, com queixa de lesões nas palmas das mãos. Referia aparecimento de pápulas eritematosas e pruriginosas, há aproximadamente 2 meses. Relatou alergia à sabão de côco e picada de inseto. Mãe com diabetes mellitus, fez uso de corticóide tópico e hidroxizine com melhora apenas do prurido. O exame histopatológico revelou hiperceratose discreta e acantose, observando-se na derme superior e média infiltrado granulomatoso consituído por céluas gigantes tipo Langerhans em torno de vasos com paredes espessadas. Há focos de dissociação e fragmentação de fibras colágenas e intensa elastose. O dignóstico de granuloma anular foi feito através de exame histopatológico, após o qual ocorreu regressão significativa das lesões

Tratamento da alopécia areata: Revisäo bibliográfica de 10 anos / Treatment of alopecia areata: review bibliografic of 10 years

Os autores fazem uma revisäo do tratamento da alopécia areata durante um período de 10 anos e concluem pela näo existência ainda de um medicamento eficaz para curar esta afecçäo