Therapy of cutaneous lupus erythematosus.

Cutaneous lupus erythematosus occurs in a spectrum from limited cutaneous disease to severe systemic disease. Chronic DLE generally follows a benign course, but rare transformation to systemic disease may occur. Subacute cutaneous LE is associated with a specific cutaneous lesion and mild to moderate systemic symptoms.

Chronic cutaneous lupus erythematosus. Clinical, laboratory, therapeutic, and prognostic examination of 62 patients.

Chronic discoid lupus erythematosus (DLE) is a common condition. Sixty-two patients with biopsy-proved, active DLE were observed and their conditions were analyzed for clinical, laboratory, and therapeutic data. Fifty-six patients had disease limited to the skin-26 localized and 30 widespread (above and below the neck).

Serum angiotensin I-converting enzyme level in patients with cutaneous sarcoidal granulomas.

In a previous study we found that only half of those patients presenting with cutaneous sarcoidal granulomas have evidence of systemic involvement. The current study was designed to determine whether abnormal angiotensin-converting enzyme (ACE) levels were predictive of multisystem disease. Serum ACE levels were determined in 15 patients with active cutaneous sarcoidal granulomas.

The value of malignancy evaluation in patients with dermatomyositis.

Dermatomyositis (DM) has been linked to internal malignancy in adult patients. However, the value of an extensive malignancy evaluation in patients with DM is controversial. Fifty-seven patients who had DM with malignancies, in whom data were available regarding the discovery of malignancy, have been analyzed.

Cutaneous bullae following acute steroid withdrawal in systemic lupus erythematosus.

A patient with systemic lupus erythematosus developed severe widespread bullae following sudden steroid withdrawal. Histologically the lesion was suggestive of leukocytoclastic vasculitis with a regenerating subepidermal bulla, but immunofluorescence on non-lesional skin was typical of lupus erythematosus. Treatment led to resolution of the bullous eruption, and despite exacerbations of the patient's lupus nephropathy, the blisters have not recurred.

Bullous pemphigoid and Hashimoto's thyroiditis.

Both bullous pemphigoid (BP) and Hashimoto's thyroiditis (HT) are suspected of being autoimmune disorders. Each disorder has been reported with other diseases associated with autoimmune phenomena. Thyroid disorders have been reported with BP, but never well documented HT with thyroid antibodies.

Pruritic urticarial papules and plaques of pregnancy (PUPPP). A clinicopathologic study.

Pruritic urticarial papules and plaques of pregnancy (PUPPP) was recently defined as an intensely pruritic cutaneous eruption occurring in the third trimester. We are reporting fifteen additional cases of this distinctive eruption. The lesions began in the third trimester in all but two patients.

Acute febrile neutrophilic dermatosis. Sweet's syndrome.

Acute febrile neutrophilic dermatosis (AFND) (Sweet's syndrome) is characterized by warm, erythematous plaques, accompanied by arthralgias, fever, and leukocytosis. A 53-year-old man was seen with chronic, recurrent, and unusually persistent AFND. The patient had a history of a gastrojejunostomy for peptic ulcer disease and had symptoms of the blind loop syndrome.

Subacute cutaneous lupus erythematosus and porphyria cutanea tarda. Report of a case.

Porphyria cutanea tarda (PCT) and various types of lupus erythematosus (LE) have been reported in the same patient on several occasions. In a large group of patients with PCT reported by Grossman et al, systemic lupus erythematosus (SLE) was found in two. Possibly LE is more common in patients with PCT; however, the mechanisms behind this coexistence are still unknown.

DNA topoisomerase I from mitochondria of Xenopus laevis oocytes.

Activity of DNA topoisomerase I has been characterized in extracts of mitochondria purified from Xenopus laevis oocytes. Several lines of evidence have been obtained for the intramitochondrial localization of the enzyme. The mitochondria-associated of DNA topoisomerase I represents 1% of the activity recovered from a total ovary population of oocytes.

Cutaneous sarcoidal granulomas and the development of systemic sarcoidosis.

Studies of patients with systemic sarcoidosis have indicated that those patients with cutaneous lesions have a poorer prognosis with a greater incidence of symptomatic pulmonary and ocular sarcoidosis. We examined 18 patients who had biopsy-proved cutaneous sarcoidosis for evidence of systemic involvement. Of the 13 patients who had no history of previously documented sarcoidosis, six had no evidence of systemic disease on history and physical examination, chest roentgenogram, pulmonary function testing, ocular examination, skin testing, and baseline laboratory testing.

Aggressive behavior of squamous cell carcinoma in a patient with preceding lymphocytic lymphoma.

Actinically induced squamous cell carcinomas of the skin (SCC) are generally considered nonaggressive and usually curable tumors. However, in patients with lymphoma or leukemia, these tumors may behave in an extremely aggressive manner. We report a case in which an actinically induced SCC occurred in a patient with preceding lymphocytic lymphoma.

Intralesional corticosteroids.

Intralesional corticosteroids are commonly used in clinical dermatology. They are an adjunct to topicals and a possible substitution for systemic corticosteroids. Intralesional corticosteroids can be injected via a syringe and needle or with a Dermo-Jet.

Vesicular pemphigoid.

The vesicular variant of bullous pemphigoid (BP) is a clinical entity in which the principal types of lesions are multiple small tense vesicles in a symmetric distribution, rather than large, more randomly distributed bullae. We present a patient who developed an intensely pruritic eruption which clinically was suggestive of typical dermatitis herpetiformis (DH), but subsequently developed large bullae typical of BP. Histologic and immunofluorescence findings, as well as initial response to systemic corticosteroids, were typical of BP.

Internal disorders associated with bullous disease of the skin. A critical review.

Acquired bullous dermatoses, including pemphigus, bullous pemphigoid (BP), dermatitis herpetiformis (DH), and porphyria cutanea tarda (PCT), have been reported in association with multiple internal disorders. These associations, as well as those cases of bullous lesions in specific systemic disorders, may prove to be important markers of internal disease. Patients with acquired bullous disorders may require specialized evaluation or follow-up.