CL_V_L: Clinical Medicine V. Lectures
1 Z. Király, Semmelweis University, Department of Dermatology, Venereology and Dermatooncology, Budapest
2 A. Kovács, Semmelweis University, Department of Dermatology, Venereology and Dermatooncology, Budapest
3 E. Kuroli, Semmelweis University, Department of Dermatology, Venereology and Dermatooncology, Budapest
4 M. Marschalkó, Semmelweis University, Department of Dermatology, Venereology and Dermatooncology, Budapest
5 B. Hidvégi, Semmelweis University, Department of Dermatology, Venereology and Dermatooncology, Budapest
Lupus erythematosus panniculitis (LEP) is a rare type of chronic cutaneous lupus erythematosus. LEP is clinically characterised by tender, subcutaneous nodules/plaques. Severe disfigurement of face and body might develop during the progression of the disease.
Our aim was to analyse clinical and histopathological characteristics of 14 patients.
We retrospectively analised the clinical records of 14 patients with LEP at Semmelweis University’s Department of Dermatology, Venereology and Dermatooncology between 2000 and 2020. The diagnosis was based on histological criterias (12/14) or expert opinion (2/14).
The male:female ratio was 1:13, the median age at presentation of symptoms was 41. Lesion localisations were the proximal upper (5/14) and lower extremities (5/14), face (4/14), chest/breast (3/14), back (1/14) and distal lower extremity (1/14). Lesions occured soliterly in 6 cases, in 8 cases multiplied (>1). Most common morphology of the lesions were active nodules/plaques (11/14), while atrophy (4/14), ulceration (2/14) and calcification (2/14) were less frequent. Discoid changes covered the lesions in 7 cases, without other localisation of DLE. In 10 cases systemic sypmtoms were observed (arthritis (8/14), renal (2/14), haematologic (5/14). 7 patients fulfilled the EULAR/ACR criterias for SLE. ANA positivity occured 12, dsDNS 5 times. The average time delay until diagnosis was 21,4 months. Histological analysis was performed 12 times, immunohistochemistry 2 times. Chloroquin was administered 5, hidroxychloroquin 3 times, while methylprednisolon was the most common (7/14) and most effective therapy.
The diagnosis of LEP was difficult at our patient group, and further research is mandatory. We found associated SLE as common as DLE, which is different from previous findings. We found corticosteroids to be the most effective treatment.
"Semmelweis 250+ Kiválósági PhD Ösztöndíj" (EFOP-3.6.3-VEKOP-16-2017-00009)
Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Hungary
Supervisor: Dr. Bernadett Hidvégi
Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine