Lupus tumidus is considered a rare subtype of chronic cutaneous lupus erythematosus, characterized by erythema and bright urticarial erythematous- violaceous. Tumid lupus erythematosus (TLE), also known as lupus erythematosus tumidus, is a highly photosensitive form of cutaneous lupus erythematosus (cutaneous. MalaCards based summary: Lupus Erythematosus Tumidus, also known as intermittent cutaneous lupus, is related to lupus erythematosus and discoid lupus .
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We suggest systemic antimalarial drugs as the treatment of choice for lupus tumidus. The main difference between the diseases is the clinical manifestation. Lupus tumidus is similar to Jessner lymphocytic infiltratein which diagnostic criteria for lupus are absent. The revised criteria for the classification of systemic lupus erythematosus: Open in a separate window. In the following years, 3 additional patients with similar skin lesions were described by the same authors 7 – 9 ; however, the next case reports of LET were not mentioned until in the German and the French literature.
Selection and preparation of skin specimens. Lupus erythematosus tumidus is a separate subtype of cutaneous lupus erythematosus. Open in a separate window. In 3 patients, the dose had to be increased to 6—6.
Lupus Erythematosus Tumidus: A Unique Disease Entity
Our data emphasize the importance of defining LET as a separate entity and demonstrate that this disease has been neglected in the literature since first described in Many are sick, young, fair-skinned females. In this report, we have analyzed the clinical, histological, photobiological, and laboratory features of 40 patients with LET.
Histological evaluation of skin lesions is necessary to confirm the diagnosis of LET, and, therefore, it represents one of the major criteria of this disease Table 3. Laboratory abnormalities or substantial ocular toxic effects caused by antimalarials did not occur in any of the patients with LET. Untreated chronic cutaneous LE tends to persist, but severity is lessened by strict sun protection and avoidance of nicotine.
Test areas were evaluated until specific lesions appeared for up to 4 weeks after the last irradiation. A general stepwise approach to treatment can be partially extrapolated from Kuhn, et al’s, series of 40 patients from a progressively more systemic and toxic lineation; sunscreen sun exposure avoidancetopical steroid treatment, antimalarial therapy, followed by systemic steroids, and other immunosuppressants.
In all lesions of LET, a distinct subepidermal edema is present, and moderate tumiuds copious interstitial mucin lupjs is detected with the use of colloidal iron staining. Table 1 Histologic features of the major clinical variants of lupus erythematosus involving the skin.
Cutaneous lupus erythematosus
However, epidermal involvement usually was not found, and smudging of the dermoepidermal junction was only occasionally detected. Twenty-two patients achieved complete or almost complete remission. Anais Brasileiros de Dermatologia.
LE nonspecific cutaneous features are most often associated with SLE. Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts. This is an Gumidus Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Med Cutan Ibero Lat Am. Luppus of the disease and therapy. These patients were placed on the same antimalarial therapy and again achieved remission within 12 weeks. Unlike subacute cutaneous lupus erythematosus SCLElupus tumidus presents no residual hypopigmentation.
Lupus tumidus: a report of two cases
The main differential diagnoses are polymorphous light eruption, Jessner’s lymphocytic infiltration of the skin, reticular erythematous mucinosis, and pseudolymphoma. Chronic cutaneous lupus erythematosus. The most affected organ is the skin, which may be involved in isolation or accompanied by systemic manifestations. In tymidus to SCLE and DLE, 30323347 follicular hyperkeratosis, epidermal atrophy, vacuolar degeneration, and thickening of the basement membrane lupks usually are not found.
The skin involvement in SLE tends to mirror systemic involvement.
Lupus erythematosus tumidus—a neglected subset of cutaneous Lupus erythematosus: Epub Apr Report of 40 Cases. Cigarette smokers who have LET may not respond very well to chloroquine.
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J Am Acad Dermatol. UVB irradiation causes keratinocyte necrosisimmune system activation and antibody formation. Systemic LE may involve heart, lung and brain with significant morbidity and mortality. Systemic corticosteroids or immunosuppressants were only temporarily necessary in 2 patients. Summary It is important to distinguish LET from other variants of CLE based on histology and clinical features since the course of disease and treatment response significantly differs. She was referred to Dermatology for an intermittent pruritic facial eruption that was clinically and histologically consistent with LET.
Criteria for positive provocative phototest results required that induced lesions clinically resembled LE, histopathological findings were compatible with LE, and skin lesions developed slowly and persisted for several days or weeks in contrast to other photodermatoses such as PLE.
The clinical picture, one of the major criteria of LET, is characterized by nonscarring, erythematous, succulent, urticarialike single or multiple plaques with no surface changes such tummidus follicular plugging Figure 1. She had complete resolution with topical corticosteroids, however the lesions returned a month later and a low dose oral prednisone taper was required to achieve remission. The eruption had been present for one week and had occurred several months ago for a similar duration and had resolved without treatment or scarring.
Tumid lupus erythematosus – Wikipedia
Andrews’ Diseases of the Skin: Histopathologic findings in lupus erythematosus tumidus: Total hemolytic complement CH50 was measured using the photometer, and lupus anticoagulant was evaluated by kaolin clotting time KCT. Purchase access Subscribe now. Given her clinical presentation and histopathologic findings, a diagnosis of lupus erythematosus tumidus LET was made. It is more prevalent in patients with skin of colour, lupsu are at greater risk of postinflammatory hyperpigmentation and hypertrophic scarring.
Features of neonatal cutaneous LE may include:.