Background: Cutaneous lupus erythematosus (CLE) is an autoimmune disease with several clinical presentations. The chronic form predominantly presents as discoid rashes but may present with less common morphological findings that can sometimes make diagnosis difficult. Comedonic lupus is a rare and underdiagnosed variant, with unknown etiology and still poorly defined treatment.
Methods: The report illustrates a series of five cases of patients diagnosed with comedonic lupus, and it reviews 18 cases previously published in the literature.
Results: The clinical presentation is of comedonal lesions, mostly located on the face, making a differential diagnosis with other benign conditions such as acne vulgaris, Favre-Racouchot syndrome, and syringoma, emphasizing the importance of clinical practice and histopathology for diagnostic confirmation.
Conclusions: There is scarcity in the literature regarding the condition and therapeutic possibilities for these cases of comedonic lupus.
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http://dx.doi.org/10.1111/ijd.16675 | DOI Listing |
Int J Dermatol
November 2024
Department of Dermatology, Rush University Medical Center, Chicago, Illinois, USA.
A 57-year-old woman on leflunomide with a history of chronic obstructive pulmonary disease and rheumatoid arthritis presented with multiple flesh-colored to hyperpigmented dome-shaped papules, scattered comedones, and underlying scarring on bilateral cheeks and chin. These dermatologic manifestations, laboratory evaluation, and punch biopsy led to a final diagnosis of acneiform or comedonal discoid lupus erythematosus (ACDLE). For patients with acneiform or comedonal lesions, ACDLE should be considered if the lesions do not improve with conventional treatment for acne vulgaris.
View Article and Find Full Text PDFJ Cutan Pathol
November 2024
Oakland University William Beaumont School of Medicine, Rochester Hills, Michigan, USA.
Background: Folliculotropic mycosis fungoides (FMF) is a rare cutaneous malignancy that can be mistaken for inflammatory diseases, such as discoid lupus erythematosus (DLE), due to the variability of histopathological findings.
Methods: This study aims to provide dermatopathologists with evidence-based histopathologic criteria to distinguish DLE from FMF by reporting overlapping and distinguishing microscopic features. Forty-three biopsies from patients with a confirmed diagnosis of DLE or FMF were graded for the presence or absence of 18 histopathologic features.
Dermatol Online J
December 2023
Centro Universitario Saude ABC Medical School, Santo Andre, Sao Paulo, Brazil Alergoskin, Santo Andre, Sao Paulo, Brazil.
We present a 57-year-old woman with cutaneous lupus erythematosus (CLE), initially treated as acne. She noted blemishes, including nodules and facial swelling for nine months associated with discrete itching of the ears. Examination showed multiple malar nodules, comedones, pustules, atrophic scars, and hyperpigmentation.
View Article and Find Full Text PDFAustralas J Dermatol
February 2024
Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Brazil.
Int J Dermatol
July 2023
Pedro Ernesto University Hospital - State University of Rio de Janeiro (HUPE - UERJ), Rio de Janeiro, Brazil.
Background: Cutaneous lupus erythematosus (CLE) is an autoimmune disease with several clinical presentations. The chronic form predominantly presents as discoid rashes but may present with less common morphological findings that can sometimes make diagnosis difficult. Comedonic lupus is a rare and underdiagnosed variant, with unknown etiology and still poorly defined treatment.
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