A Clinical and Histopathological Review on 18 Cases of Lupus Erythematosus Tumidus / 대한피부과학회지

ABSTRACT

BACKGROUND: Lupus erythematosus tumidus (LET) is a rare subset of chronic cutaneous lupus erythematosus, and LET is clinically characterized by erythematous, succulent, urticarial plaques on the sun-exposed areas and LET is histopathologically characterized by the presence of perivascular and periadnexal lymphocytic infiltrates with interstitial mucin deposition. OBJECTIVE: We investigated the clinical and histopathological features of LET in Korean patients. METHODS: A retrospective study was conducted on 18 patients who were diagnosed with LET between 1993 and 2010. The clinical characteristics, histopathological and laboratory findings, association with other subsets of lupus and the course of disease were analyzed. RESULTS: LET occurred predominantly in females, with the gender ratio being 1 : 8. The mean age at diagnosis was 31.3 years. Two of 18 patients (11.1%) were previously diagnosed with systemic lupus erythematosus (SLE) or they had discoid lupus erythematosus (DLE) simultaneously. The most common clinical features were erythematous patches, nodules or plaques and the most common site was the face. Eight of eighteen patients (44.4%) had photosensitivity and this value was lower than that of the previous reports. The antinuclear antibody (ANA) was negative or weakly positive in 13/15 (86.7%) cases. The main histopathological characteristics were perivascular and/or periadnexal lymphocytic infiltrates, and interstitial mucin deposition. Epidermal changes were absent or there were minimal changes. The treatments included antimalarial drugs, dapsone and topical and systemic corticosteroid. The patients showed a good response to the treatments without scarring. CONCLUSION: A clinicopathological review of 18 LET cases revealed results that were similar to those of the previous reports, although there were some differences in the gender ratio and frequency of photosensitivity. Further studies are needed to elucidate the cause of such differences.