Systemic sclerosis with keloidal nodules.

Nodular sclerosis is a rare form of presentation related to both systemic and localized forms of scleroderma. We describe the case of a patient with nodular sclerosis in order to alert the medical community to recognize this entity.

Systemic sclerosis with keloidal nodules / Esclerose sistemica com nodulos queloidianos

Nodular sclerosis is a rare form of presentation related to both systemic and localized forms of scleroderma. We describe the case of a patient with nodular sclerosis in order to alert the medical community to recognize this entity.

Esclerose nodular é uma forma de apresentação cutânea rara relacionada tanto com a forma sistêmica como com a forma localizada da esclerodermia. Descrevemos aqui o caso de uma paciente esta forma nodular de esclerose, no sentido de alertar a comunidade médica para o reconhecimento dessa entidade.

Prognosis of patients with systemic lupus erythematosus and discoid lesions.

BACKGROUND: It has been observed that patients with systemic lupus erythematosus and discoid lesions have a milder systemic disease. OBJECTIVE: To compare the clinical, demographic and autoantibody profile of systemic lupus erythematosus patients with and without discoid lesions. METHODS: We carried out a retrospective study involving 288 systemic lupus erythematosus patients who met at least four classification criteria of the American College of Rheumatology for systemic lupus erythematosus, comparing the clinical, serological and demographic factors between patients with and without discoid manifestations. RESULTS: Of the 288 patients, 13.8% had discoid lesions. Univariate analysis found no differences in the prevalence of malar rash, photosensitivity, arthritis, serositis, leukopenia, lymphopenia and hemolytic anemia or anemia of the central nervous system (p = ns). Renal lesions were more common in those without discoid lesions (p =0.016), and hemolysis (p<0.0001) was more common in those with discoid lesions. Regarding the profile of autoantibodies, only the anti-RNP antibody was more common in those with discoid events (p =0.04). In a logistic regression study, only the renal lesions and anti-RNP maintained their associations with discoid manifestations. CONCLUSION: Patients with lesions of systemic lupus erythematosus and discoid lesions have lower prevalence of renal involvement and a greater presence of anti RNP.

Prognosis of patients with systemic lupus erythematosus and discoid lesions / Prognostico de pacientes com lupus eritematoso sistemico e lesoes discoides

BACKGROUND: It has been observed that patients with systemic lupus erythematosus and discoid lesions have a milder systemic disease. OBJECTIVE: To compare the clinical, demographic and autoantibody profile of systemic lupus erythematosus patients with and without discoid lesions. METHODS: We carried out a retrospective study involving 288 systemic lupus erythematosus patients who met at least four classification criteria of the American College of Rheumatology for systemic lupus erythematosus, comparing the clinical, serological and demographic factors between patients with and without discoid manifestations. RESULTS: Of the 288 patients, 13.8% had discoid lesions. Univariate analysis found no differences in the prevalence of malar rash, photosensitivity, arthritis, serositis, leukopenia, lymphopenia and hemolytic anemia or anemia of the central nervous system (p = ns). Renal lesions were more common in those without discoid lesions (p =0.016), and hemolysis (p<0.0001) was more common in those with discoid lesions. Regarding the profile of autoantibodies, only the anti-RNP antibody was more common in those with discoid events (p =0.04). In a logistic regression study, only the renal lesions and anti-RNP maintained their associations with discoid manifestations. CONCLUSION: Patients with lesions of systemic lupus erythematosus and discoid lesions have lower prevalence of renal involvement and a greater presence of anti RNP. .

FUNDAMENTOS: Existe a observação de que pacientes com lúpus eritematoso sistêmico e lesões discoides têm uma doença sistêmica mais branda. OBJETIVO: Comparar o perfil clínico, demográfico e de autoanticorpos de pacientes com lúpus eritematoso sistêmico com e sem lesões discoides. MÉTODOS: Estudo retrospectivo de 288 pacientes com lúpus eritematoso sistêmico que satisfizeram pelo menos 4 critérios classificatórios do Colégio Americano de Reumatologia para o diagnóstico de lúpus eritematoso sistêmico, comparando-se os achados clínicos, sorológicos e demográficos entre pacientes com e sem manifestações discoides. RESULTADOS: Dos 288 pacientes, 13,8% tinham lesões discoides. Na análise univariada não se encontraram diferenças quanto à prevalência de eritema malar, fotossensibilidade, artrite, serosite, leucopenia, linfopenia e anemia hemolítica ou de sistema nervoso central (p=ns). Lesões renais foram mais comuns naqueles sem lesão discoide (p =0,016), e a hemólise (p<0.0001) foi mais comum nos com lesão discoide. No que se refere ao perfil de autoanticorpos apenas o anticorpo anti-RNP foi mais comum naqueles com manifestações discoides (p=0,04). Em estudo por regressão logística, só as lesões renais e o anticorpo anti-RNP mantiveram suas associações com manifestações discoides. CONCLUSÃO: Pacientes de lúpus eritematoso sistêmico com lesões discoides têm menor prevalência de envolvimento renal e uma maior presença do anticorpo anti RNP. .