Nagao Kyoko, Chen Ko-Ron
Department of Dermatology, Ogikubo Hospital, Suginami-ku, Tokyo, Japan.
J Dermatol. 2006 Mar;33(3):187-90. doi: 10.1111/j.1346-8138.2006.00043.x.
A case of lupus erythematosus/lichen planus overlap syndrome (LE/LP overlap syndrome) was reported. A 53-year-old woman developed violaceous erythema around the nostrils and the upper lips and atrophic scaly erythema on the cheeks and neck. Histopathological studies revealed that the patient had distinct discoid lupus erythematosus (DLE), LP, and a lesion with combined features of DLE and LP. Direct immunofluorescent (DIF) studies of the mixed lesion revealed both prominent immunoglobulin (Ig)G deposits in a granular pattern at the basement membrane zone (BMZ) and IgM deposits in the clusters of cytoid bodies; the former are more typical of LE and the latter more of LP. DIF features in combination were unique for LE/LP overlap syndrome. The patient was satisfactorily treated with topical tacrolimus. While reports support the effectiveness of tacrolimus in either LE or LP, this is the first case of LE/LP overlap syndrome treated with topical tacrolimus.
报告了一例红斑狼疮/扁平苔藓重叠综合征(LE/LP重叠综合征)。一名53岁女性在鼻孔和上唇周围出现紫红色红斑,脸颊和颈部出现萎缩性鳞屑红斑。组织病理学研究显示,该患者有典型的盘状红斑狼疮(DLE)、扁平苔藓(LP),以及具有DLE和LP联合特征的病变。对混合病变进行直接免疫荧光(DIF)研究发现,在基底膜带(BMZ)有显著的颗粒状免疫球蛋白(Ig)G沉积,在细胞样体簇中有IgM沉积;前者更具LE的典型特征,后者更具LP的典型特征。联合的DIF特征是LE/LP重叠综合征所独有的。该患者局部使用他克莫司治疗效果良好。虽然有报告支持他克莫司对LE或LP有效,但这是首例局部使用他克莫司治疗的LE/LP重叠综合征病例。