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Inicio Medicina Clínica (English Edition) Lupus panniculitis: Clinicopathological features of a series of 12 patients
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Vol. 151. Issue 11.
Pages 444-449 (December 2018)
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Vol. 151. Issue 11.
Pages 444-449 (December 2018)
Clinical report
DOI: 10.1016/j.medcle.2018.10.007
Lupus panniculitis: Clinicopathological features of a series of 12 patients
Paniculitis lúpica: características clínico-patológicas de una serie de 12 pacientes
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Carlos González-Cruza,
Corresponding author
, Gloria Aparicio Española, Berta Ferrer Fàbregab, Víctor Cabezas Calderóna, Mario Giner Pichelb, Vicente García-Patos Brionesa
a Servicio de Dermatología, Hospital Universitari Vall d’Hebron, Barcelona, Spain
b Servicio de Anatomía Patológica, Hospital Universitari Vall d’Hebron, Barcelona, Spain
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Table 1. Main clinical and histopathological characteristics of our series.
Abstract
Background and objective

Lupus panniculitis (LP) is a rare variant of chronic cutaneous lupus erythematosus, which diagnosis requires clinicopathological correlation, especially in those patients without any other manifestation of lupus erythematosus (LE). According to the phase when the biopsy is performed, histological findings can be non-specific. Few series have been published to date. Hence, we report our own experience in the diagnosis and management of this disease.

Materials and methods

We conducted a retrospective descriptive clinicopathological study of 12 patients diagnosed in our centre.

Results

All the patients had painful and recurrent plaques and/or nodules, with a predilection for proximal extremities, face and scalp. Histopathologic examination showed mostly lobular panniculitis and lymphoplasmacytic infiltrate. For the diagnosis, we also considered the coexistence of other clinical manifestations of LE as well as the expression of CD123 by immunohistochemistry. In 3 patients, LP was the first manifestation of LE.

Conclusions

The diagnosis of LP can be difficult. The presence of other clinical and/or histological manifestations of LE along with immunohistochemistry techniques could help in the differential diagnosis with other panniculitis.

Keywords:
Lupus panniculitis
Lupus erythematosus profundus
Cutaneous lupus
Resumen
Antecedentes y objetivo

La paniculitis lúpica (PL) es una forma infrecuente de lupus eritematoso cutáneo crónico, cuyo diagnóstico requiere una adecuada correlación clínico-patológica, especialmente si constituye la primera manifestación de lupus eritematoso (LE). Dependiendo del estado evolutivo de las lesiones, la biopsia puede mostrar cambios poco específicos que dificultan el diagnóstico. Existen pocas series publicadas sobre esta entidad. Aportamos la experiencia de nuestro centro en su diagnóstico y manejo.

Materiales y métodos

Estudio clínico-patológico retrospectivo descriptivo de 12 casos diagnosticados de PL en nuestro servicio.

Resultados

Todos los pacientes tenían placas y/o nódulos dolorosos recurrentes, característicamente localizados en la zona proximal de las extremidades, la cara y el cuero cabelludo. En la biopsia había paniculitis de predominio lobulillar con infiltrados linfoplasmocitarios. Esto, junto con la coexistencia de otras manifestaciones clínicas de LE y el estudio de expresión de CD123, permitió establecer el diagnóstico de PL. En 3 pacientes la PL fue la primera manifestación de LE.

Conclusiones

La PL es una entidad de difícil diagnóstico. La presencia de otras manifestaciones clínicas y/o histológicas de lupus y la utilización de técnicas inmunohistoquímicas pueden ser útiles para el diagnóstico diferencial con otras paniculitis.

Palabras clave:
Paniculitis lúpica
Lupus eritematoso profundo
Lupus cutáneo

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