PhD Scientific Days 2021

Budapest, 7-8 July 2021

CL_V_L: Clinical Medicine V. Lectures

Clinicopathologic Study of 14 Patients with Lupus Erythematosus Panniculitis

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

Text of the abstract

Introduction
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.

Aims
Our aim was to analyse clinical and histopathological characteristics of 14 patients.

Methods
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).

Results
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.

Conclusion
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.

Funding
"Semmelweis 250+ Kiválósági PhD Ösztöndíj" (EFOP-3.6.3-VEKOP-16-2017-00009)

kiraly.zsofia@phd.semmelweis.hu
Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Hungary
Supervisor: Dr. Bernadett Hidvégi

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine